Bleeding Complications After Transcutaneous Kidney Biopsy in Patients With Systemic Amyloidosis: Single-Center Experience in 101 Patients
Bleeding Complications After Transcutaneous Kidney Biopsy in Patients With Systemic Amyloidosis: Single-Center Experience in 101 Patients
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DOI：
10.1053/j.ajkd.2008.05.022
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发表时间：
2008-12-01
影响因子：
13.2
通讯作者：
Leung, Nelson
中科院分区：
文献类型：
--
作者：
Soares, Sandra M.;Fervenza, Fernando C.;Leung, Nelson
背景：出血是肾活检后最常见的并发症之一。淀粉样变性被认为是危险因素之一，但这一点尚未在大型研究中得到证实。我们进行这项研究是为了评估淀粉样变性患者肾活检后的出血风险。研究设计：回顾性研究。设置和参与者：101 名患有淀粉样变性的患者和 188 名没有淀粉样变性的患者在大型医疗中心接受门诊经皮肾活检，且不存在部分凝血活酶时间、凝血酶原时间国际标准化比值异常或血小板计数和/或未控制的高血压。预测因素：淀粉样变性的临床诊断。结果和测量：通过影像学手段证实肾活检后出血。如果需要输血、住院或其他侵入性操作，则出血被定义为严重出血；如果不需要这些干预措施，则出血被定义为轻微出血。 结果：9.9% 的淀粉样变性患者和 10.6% 的对照者观察到肾活检后出血（P = 0.8）。 4% 的淀粉样变性患者和 2.1% 的对照患者出现严重出血（P = 0.4）。每组三名患者需要输血和选择性肾血管造影。除对照组中的 1 名患者外，所有患者均接受了栓塞治疗。 局限性：回顾性数据分析和总体低事件发生率不允许进行独立的危险因素分析。 结论：本研究表明，在没有止血障碍和/或未控制的高血压的情况下，系统性淀粉样变性患者肾活检期间的出血风险不会增加。可以使用与无淀粉样变性患者相同的筛查标准安全地进行肾活检。
Background: Bleeding is one of the most common complications after kidney biopsy. Amyloidosis is thought to be 1 of the risk factors, but this has not been confirmed in a large study. We performed this study to assess the risk of bleeding after kidney biopsy in patients with amyloidosis.Study Design: Retrospective study.Settings & Participants: 101 patients with and 188 patients without amyloidosis undergoing outpatient percutaneous kidney biopsy at a major medical center in the absence of abnormal partial thromboplastin time, prothrombin time international normalized ratio, or platelet count and/or uncontrolled hypertension.Predictor: Clinical diagnosis of amyloidosis.Outcomes & Measurements: Post-kidney biopsy bleeding confirmed by means of imaging. Bleeding was defined as major if it required blood transfusion, hospital admission, or other invasive procedures and minor if none of these interventions were needed.Results: Post-kidney biopsy bleeding was observed in 9.9% of patients with amyloidosis and 10.6% of controls (P = 0.8). Bleeding was major in 4% of patients with amyloidosis and 2.1% of controls (P = 0.4). Three patients from each group required blood transfusions and selective renal angiography. All except 1 patient from the control group underwent embolization.Limitations: Retrospective data analysis and overall low event rate did not allow for independent risk-factor analysis.Conclusions: The present study suggests that in the absence of a hematostatic disorder and/or uncontrolled hypertension, bleeding risk during kidney biopsy is not increased in patients with systemic amyloidosis. Kidney biopsy can be performed safely using the same screening criteria as for patients without amyloidosis.