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September 19, 1977

Nonhemorrhagic Decrements in Hematocrit Values After Percutaneous Renal Biopsy

Author Affiliations

From the Department of Internal Medicine, University of Virginia School of Medicine, Charlottesville, Va.

JAMA. 1977;238(12):1266-1268. doi:10.1001/jama.1977.03280130048014

Seventy patients without bleeding after a percutaneous renal biopsy (PCB) were studied to define the incidence of decrements in hematocrit values, hypotension, and bradycardia. Hematocrit values decreased 0.5% in 60% of the patients, ≥1% in 44%, and ≥2% in 34% of patients. After PCB, an increase of ≥1% occurred in 55% of the patients with hematocrit nadirs of ≥1%. Hematocrit values increased 3.0%±0.6% in 8/19 patients with a previous decrease of ≥2% but continued to decrease in 13% of the patients. A weight gain or positive fluid balance occurred in 29%, hypotension in 7%, and relative bradycardia in 4% of the patients. These studies show that a decrease in hematocrit values and hypotension may occur in patients after PCB without bleeding. This may result from hemodilution and increased parasympathetic discharge and as part of a natural spectrum of decreasing hematocrit levels coincident with PCB.

(JAMA 238:1266-1268, 1977)