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73 m (29.2% vs. 13%, p = .032). Dialysis was a risk factor, while pre KBx blood transfusion, diabetes and higher serum albumin were protective against any complication. KBx was more likely to make a significant difference in management in those with eGFR 15-29 ml/min/1.73m (44.1% vs. 11.1%, p .001). Increasing age, lower serum creatinine and albumin were independently associated with KBx utility. KBx is relatively safe in severe kidney disease but its risk to benefit balance needs to be carefully considered when eGFR is 15 ml/m
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