Manual compression and reflex syncope in native renal biopsy

Yoichi Takeuchi, Yoshie Ojima, Saeko Kagaya, Satoshi Aoki, Tasuku Nagasawa

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Complications associated with diagnostic native percutaneous renal biopsy (PRB) must be minimized. While life threatening major complications has been extensively investigated, there is little discussion regarding minor bleeding complications, such as a transient hypotension, which directly affect patients’ quality of life. There is also little evidence supporting the need for conventional manual compression following PRB. Therefore, this study evaluated the relationship between minor and major complications incidence in patients following PRB with or without compression. Methods: This single-center, retrospective study included 456 patients (compression group: n = 71; observation group: n = 385). The compression group completed 15 min of manual compression and 4 h of subsequent strict bed rest with abdominal bandage. The observation group completed 2 h of strict bed rest only. The primary outcome of interest was transient symptomatic hypotension (minor event). Results: Of the 456 patients, 26 patients encountered intraoperative and postoperative transient hypotension, which were considered reflex syncope without tachycardia. Univariate analysis showed that symptomatic transient hypotension was significantly associated with compression. This association remained significant, even after adjustment of covariates using multivariate logistic regression analysis (adjusted odds ratio 3.27; 95% confidential interval 1.36–7.82; P = 0.0078). Conclusion: Manual compression and abdominal bandage significantly increased the frequency of reflex syncope during native PRB. It is necessary to consider the potential benefit and risk of compression maneuvers for each patient undergoing this procedure.

Original languageEnglish
Pages (from-to)1100-1107
Number of pages8
JournalClinical and experimental nephrology
Volume22
Issue number5
DOIs
Publication statusPublished - 2018 Oct 1

Keywords

  • Complications
  • Logistic regression model
  • Percutaneous renal biopsy
  • Quality of life
  • Standard practice

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

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