# Preprocedural Anxiety in Kidney Biopsy: A Prospective Study of Prevalence, Risk Factors, and Physiological Correlates

## TL;DR

This study finds that over half of patients feel significant anxiety before kidney biopsies, though it doesn't affect blood pressure changes.

## Contribution

The study is the first to prospectively examine preprocedural anxiety in kidney biopsy patients and its physiological correlates.

## Key findings

- 55% of patients experienced clinically significant anxiety before kidney biopsy.
- Higher serum creatinine and prior kidney biopsy history were linked to increased anxiety.
- Anxiety did not independently affect blood pressure or pulse rate changes before the procedure.

## Abstract

Background/Objectives: Despite the widespread recognition of preprocedural anxiety in awake invasive procedures, there is a paucity of data examining its prevalence and clinical impact in patients undergoing percutaneous kidney biopsy. This study aimed to determine the prevalence of preprocedural anxiety, assess its association with peri-procedural hemodynamic parameters, and identify factors associated with elevated anxiety. Methods: In this prospective observational study, 151 adults scheduled for percutaneous kidney biopsy between June 2023 and January 2025 were enrolled. Anxiety was assessed 24 h before the procedure using the Thai State–Trait Anxiety Inventory Y1 (STAI-Y1). Blood pressure and pulse rate were measured at baseline and 30 min before biopsy. Mixed-effects models evaluated associations between anxiety and hemodynamic changes, and logistic regression identified predictors of anxiety. Results: Clinically significant anxiety (STAI-Y1 ≥ 40) was present in 55% of patients, with 43.4% reporting very high anxiety. Anxiety status was not independently associated with changes in systolic or diastolic blood pressure or pulse rate. However, diastolic blood pressure increased significantly from baseline to preprocedural across all patients (mean increase 5.45 mmHg; p = 0.008), irrespective of anxiety. Higher serum creatinine (OR 1.29; p = 0.012) and a history of previous kidney biopsy (OR 4.28; p = 0.004) were independently associated with anxiety. Conclusions: Preprocedural anxiety is highly prevalent among patients undergoing kidney biopsy but does not independently influence peri-procedural hemodynamic parameters. Targeted screening and supportive interventions may benefit patients at increased risk of anxiety.