214 - Hemostatic Agents After Renal Biopsy: Helpful or Habit?

Purpose: To evaluate the impact of hemostatic agents and body mass index (BMI) on bleeding risks following percutaneous renal biopsy.

Materials and Methods: A retrospective review was done on patients who underwent percutaneous renal biopsy between 2020-2025 at a tertiary care center. Patients were grouped by use of hemostatic agent in biopsy tract versus no hemostatic agent following percutaneous renal biopsy. BMI and other patient demographics were also collected. The primary outcome was post-biopsy bleeding, defined as expanding hematoma on post-procedural imaging, hematoma associated with painful abdomen/flank, hemoglobin drop ≥2 g/dL, or syncope/hypotension.

Results: Hemostatic agent use was evaluated as a categorical variable using Fisher’s exact test and showed no association with bleeding. Among 94 patients who received a hemostatic agent, 14 (15%) experienced hemorrhage compared with 31 of 206 patients (15%) who did not use hemostatic agent (p=1.0). In contrast, body mass index (BMI) was analyzed as a continuous variable in multivariable logistic regression. Controlled values included age, history of tobacco use, diabetes, and hypertension, number of specimens collected, and INR values. Results show BMI is inversely associated with bleeding risk. Each unit increase in BMI was associated with a 5% relative reduction in odds of bleeding (OR 0.95, 95% CI 0.90–0.99, p=0.039).

Conclusion: Higher BMI appeared protective against bleeding, while the use of hemostatic agents did not reduce bleeding complication rates. These findings suggest that routine placement of hemostatic agents may not provide added benefit and should not be used indiscriminately. This is especially important due to risk of hemostatic agent migration. Although major bleeding risks are low after percutaneous renal biopsy, a more judicious approach could improve resource allocation to ensure that adjunctive hemostatic interventions are reserved for patients at truly elevated risk. Our findings highlight the importance of post-biopsy interventions depending on patient-specific risk factors.