MP322PREVALENCE AND RISK FACTORS OF HEMORRHAGIC COMPLICATIONS AFTER KIDNEY ALLOGRAFT BIOPSY: RESULTS FROM THE JAPANESE NATIONWIDE CLAIM DATABASE

Abstract

Introduction and Aims: After kidney allograft biopsy, hemorrhage is one of the major complications. However, safety and risk factors of hemorrhagic complications after kidney allograft biopsy remain unclear. Our aims in this study are to investigate the incidence of hemorrhagic complications after kidney allograft biopsy and identify risk factors of the complications using Japanese representative claim database which covers approximately 50% of inpatient admission to acute care hospitals. Method(s): Using a large claims-based data of the Diagnosis Procedure Combination database in Japan, we identified inpatients aged more than or equal to 15 years, coded as post kidney transplant status, and underwent kidney allograft biopsy within four days after admission during July to December in years of 2007 to 2010 (total 24 months). We assessed patients' age, sex, body mass index (BMI), Charlson Comorbidity Index (CCI), hemorrhagic complications, and outcomes. Univariate logistic regression was used to identify the risk factors of hemorrhagic complications. Result(s): A total of 2438 patients were identified from 164 hosptitals. Mean age of the patients was 44.0 years, and proportion of male was 62%. Overall, hemorrhagic complications occurred in 25 patients (1.0%), including red blood cell transfusion (14, 0.6%); hemorrhagic events on diagnostic codes (10, 0.4%); evacuation of intravesical blood clots (1, 0.04%). No angiography, endovascular procedure, and nephrectomy were observed. In-hospital deaths within 30 days after biopsy occured in 2 patients (0.08%), however these patients did not suffer from hemorrhagic complications. Significantly higher complication incidence was observed in patients aged 15-29 years (OR 3.44, 95% CI 1.08-10.9) with reference to middle-aged group (30-44 years). No significant relationship was observed between hemorrhagic complications and sex, BMI, and CCI. Conclusion(s): Kidney allograft biopsy was safe procedure in Japan; however, careful attention would be required when young patients undergo kidney allograft biopsy.