Arterial Stiffness is an Independent Risk Factor for Anemia After Percutaneous Native Kidney Biopsy

Kidney Blood Press Res. 2017;42(2):284-293. doi: 10.1159/000477453. Epub 2017 May 25.


Background/aims: Bleeding is the most common complication after renal biopsy. Although numerous predictors of bleeding have been reported, it remains unclear whether arterial stiffness affects bleeding complications.

Method: We performed an observational study of the renal biopsies performed in our division over an approximately 6-year period (May 2010 to May 2016). The clinical and laboratory factors were analyzed to reveal the risk factors associated with bleeding, with a focus on anemia (defined as a ≥10% decrease in hemoglobin [Hb] after biopsy). The brachial-ankle pulse wave velocity (baPWV) was measured to evaluate arterial stiffness.

Results: This study included 462 patients (male, n=244; female, n=218). Anemia (defined above) was observed in 54 patients (11.7%). The risk of anemia was higher in women, older patients, and patients with lower serum albumin, lower eGFR and lower diastolic blood pressure after biopsy. We then performed a further analysis of 187 patients whose baPWV data were available. Multivariate analysis revealed that a higher baPWV was an independent risk factor for anemia. ROC analysis for predicting anemia found that a baPWV value of 1839 cm/s had the best performance (AUC 0.689).

Conclusion: An increased baPWV may be a more valuable predictor of bleeding than any of the other reported risk factors.

Keywords: Bleeding; Brachial-ankle pulse wave velocity; Hemoglobin; Renal biopsy.

Publication types

  • Observational Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia / etiology*
  • Ankle Brachial Index
  • Biopsy / adverse effects
  • Female
  • Hemoglobins
  • Hemorrhage
  • Humans
  • Kidney Diseases / complications*
  • Kidney Diseases / pathology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pulse Wave Analysis
  • Retrospective Studies
  • Risk Factors
  • Vascular Stiffness*
  • Young Adult


  • Hemoglobins