Thromboelastography versus bleeding time for risk of bleeding post native kidney biopsy.
Ren Fail
; 42(1): 10-18, 2020 Nov.
Article
en En
| MEDLINE
| ID: mdl-31842662
ABSTRACT
Introduction:
The risk of bleeding has led to screening of the primary hemostasis before renal biopsy. A bleeding time test (BT) is considered standard practice, but reliance on this test is controversial and its benefits remain questionable. A possible alternative is thromboelastography (TEG). However, data regarding TEG in patients with renal dysfunction is limited.Objectives:
To determine TEG abnormalities and their consequences in patients who underwent a native kidney biopsy.Methods:
A retrospective study of 417 consecutive percutaneous native renal biopsies performed in our Center. If serum creatinine >1.5 mg/dL, the patient underwent either a BT test (period A, January 2015-31 December 2016) or TEG (period B, January 2017-August 2018). In patients with prolonged BT, or an abnormal low maximal amplitude (MA) parameter of TEG, or suspected clinical uremic thrombopathy, the use of desmopressin acetate (DDAVP) was considered.Results:
Most biopsies (90.6%) were done by the same dedicated radiologist. Fifty-one patients had a BT test, which was normal in all tested patients. Seventy-one patients underwent TEG, and it was abnormal in 34 of them, most patients had combined abnormalities. The only parameter related to abnormal TEG was older age (Odds Ratio 1.21 [95% CI 1.09-2.38] p = 0.04 for abnormal Kinetics; OR 1.37 (1.05-1.96) p = 0.037 for abnormal MA). Twenty-six patients (6.23%) had bleeding complications. Risk of bleeding was significantly related to age (1.4 [1.11-7.48] p = 0.04), systolic blood pressure (1.85 [1.258-9.65] p = 0.02), and serum creatinine (1.21 [1.06-3.134] p = 0.048).Conclusions:
TEG abnormalities in patients with renal dysfunction are variable and fail to predict bleeding during kidney biopsy. The decision to administer DDAVP as a preventive measure during these procedures should be based on clinical judgment only.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Tromboelastografía
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Hemostáticos
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Hemorragia Posoperatoria
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Enfermedades Renales
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ren Fail
Asunto de la revista:
NEFROLOGIA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Israel