Abstract
Kidney biopsy can result in bleeding complications. Prebiopsy testing using bleeding time (BT) is controversial. New whole blood haemostasis tests, such as platelet function analyser-100 (PFA-100) and multiple electrode aggregometry (MEA), might perform better. We postulated that PFA-100 would be suitable to replace BT prebiopsy. In 154 patients, transplanted kidney biopsies were performed after measurement of bleeding time, PFA-100, MEA and mean platelet volume (MPV). Bleeding outcome (haemoglobin (Hb) drop, haematuria (+/- bladder catheterization), ultrasound finding of a bleeding, need for (non)surgical intervention and/or transfusion) after the biopsy was correlated to each test. Male-female ratio was 2:1. 50% had a surveillance biopsy at either three or 12months. Around 17% (had) used acetylsalicylic acid (ASA) prebiopsy. Of 17 bleeding events, one subject needed a transfusion. Most bleeding events were Hb reductions over 1mmol/l and all resolved uneventful. BT, PFA-100, MEA and MPV did not predict a bleeding outcome; prior ASA use however could (odds ratio 3.19; 95%-CI 1.06 to 9.61). Diagnostic performance data and Bland-Altman analysis showed that BT could not be substituted by PFA-100. ASA use was the best determinant of bleeding after kidney biopsy. Routine haemostasis testing prebiopsy has no added value.
Original language | English |
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Pages (from-to) | 302-312 |
Number of pages | 11 |
Journal | Transplant International |
Volume | 31 |
Issue number | 3 |
DOIs | |
Publication status | Published - 1 Mar 2018 |
Keywords
- coagulation
- kidney biopsy
- platelet function
- point-of-care
- screening
- PERCUTANEOUS RENAL BIOPSY
- PLATELET-FUNCTION ANALYZER
- BLEEDING-TIME TEST
- COMPLICATIONS
- SAFETY
- DYSFUNCTION
- EXPERIENCE
- MANAGEMENT
- HEMATURIA
- CHILDREN