Major Bleeding of Transjugular Native Kidney Biopsies. A French Nationwide Cohort Study.
Kidney Int Rep
; 6(10): 2594-2603, 2021 Oct.
Article
em En
| MEDLINE
| ID: mdl-34622099
ABSTRACT
INTRODUCTION:
The risk of bleeding associated with transjugular kidney biopsies is unclear, and which patients are the best candidates for this route is unknown.METHODS:
This was a retrospective cohort study comparing proportion of bleeding associated with transjugular versus percutaneous native kidney biopsies in all patients in France in the 2010-2019 period. Major bleeding at day 8 (i.e., blood transfusions, hemorrhage/hematoma, angiographic intervention, nephrectomy) and risk of death at day 30 were assessed, and we used a bleeding risk score initially developed for the percutaneous route.RESULTS:
Our analysis included 60,331 patients (transjugular route 5305; percutaneous route 55,026 patients). The observed proportion of major bleeding varied widely (transjugular vs. percutaneous) 0.4% versus 0.5% for the lowest risk scores (0-4) to 19.1% versus 30.8% for the highest risk scores (≥35). Transjugular was more frequently used than percutaneous route (39% vs. 24%) when the risk score was ≥20 (15,133/60,331; 25% of all patients). Transjugular was associated with a lower risk of major bleeding than percutaneous route in multivariate analyses (odds ratio [OR] 0.88 [0.78-0.99]), especially for scores ≥20 (OR 0.83 [0.72-0.96], (i.e., 25% of patients). Major bleeding was associated with an increased risk of death both for transjugular (OR 1.77 [1.00-3.14]) and percutaneous (OR 1.80 [1.43-2.28]) routes.CONCLUSIONS:
The transjugular route is independently associated with a lower risk of bleeding than the percutaneous route, especially in high-risk patients identified by a preprocedure risk score ≥20 (i.e., 25% of patients). Major bleeding is associated with an increased risk of death for both routes.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Idioma:
En
Revista:
Kidney Int Rep
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
França