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Major Bleeding of Transjugular Native Kidney Biopsies. A French Nationwide Cohort Study

2021; Elsevier BV; Volume: 6; Issue: 10 Linguagem: Inglês

10.1016/j.ekir.2021.07.011

2468-0249

Gerhard Hindricks, Tatjana Potpara, Nikolaos Dagres, Elena Arbelo, Jeroen J. Bax, Carina Blomström‐Lundqvist, Giuseppe Boriani, Manuel Castellá, Gheorghe‐Andrei Dan, Polychronis Dilaveris, Laurent Fauchier, Gerasimos Filippatos, Jonathan M. Kalman, Mark La Meir, Deirdre A. Lane, Jean‐Pierre Lebeau, Maddalena Lettino, Gregory Lip, Fausto J. Pinto, G. Neil Thomas, Marco Valgimigli, Isabelle C. Van Gelder, Bart Van de Putte, Caroline L Watkins, Paulus Kirchhof, Michael Kühne, Victor Aboyans, Anders Ahlsson, Paweł Balsam, Johann Bauersachs, Stefano Benussi, Axel Brandes, Frieder Braunschweig, A. John Camm, Davide Capodanno, Barbara Casadei, David Conen, Harry Crijns, Victoria Delgado, Dobromir Dobrev, Heinz Drexel, Lars Eckardt, Donna Fitzsimons, Thierry Folliguet, Christopher Gale, Bülent Görenek, Karl Georg Hæusler, Hein Heidbüchel, Bernard Iung, Hugo Katus, Dipak Kotecha, Ulf Landmesser, Christophe Leclercq, Basil S. Lewis, Julia Mascherbauer, José Luís Merino, Béla Merkely, Lluı́s Mont, Christian Mueller, Klaudia Nagy, Jonas Oldgren, Nikola Pavlović, Roberto F.E. Pedretti, Steffen E. Petersen, Jonathan P. Piccini, Bogdan A. Popescu, Helmut Pürerfellner, Dimitrios Richter, Marco Roffi, Andrea Rubboli, Douglas S. Scherr, Renate B. Schnabel, Iain Simpson, Е. V. Shlyakhto, Moritz F. Sinner, Jan Steffel, Miguel Sousa‐Uva, Piotr Suwalski, Martin Svetlošák, Rhian M. Touyz, G. Neil Thomas, T. Delassi, Hamayak Sisakian, Alexandr Chasnoits, Michel De Pauw, Elnur Smajić, Tchavdar Shalganov, Panayiotis Avraamides, Josef Kautzner, Christian Gerdes, Ahmad Abd Alaziz, Priit Kampus, Pekka Raatikainen, Serge Bovéda, Giorgi Papiashvili, Vassilios Vassilikos, Zoltán Csanádi, Davíð O. Arnar, Joseph Galvin, Alon Barsheshet, Pasquale Caldarola, Amina Rakisheva, Ibadete Bytyçi, Alina Kerimkulova, Oskars Kalējs, Mario Njeim, Aras Puodžiūkynas, Laurent Groben, Mark Sammut, Aurel Grosu, Aneta Bošković, Abdelhamid Moustaghfir, Natasja de Groot, Lidija Poposka, Ole-Gunnar Anfinsen, Przemysław Mitkowski, Diogo Cavaco, Călin Siliște, E. N. Mikhaylov, Luca Bertelli, Dejan Kojić, Róbert Hatala, Zlatko Fras, Fernando Arribas, Tord Juhlin, Christian Sticherling, Leïla Abid, İlyas Atar, O. S. Sychov, Matthew Bates, Н. У. Закиров, Jean‐Michel Halimi, Philippe Gatault, Hélène Longuet, Christelle Barbet, Annabelle Goumard, Juliette Gueguen, Nicolas Goin, Bénédicte Sautenet, Julien Herbert, Arnaud Bisson,

Renal and Vascular Pathologies

The risk of bleeding associated with transjugular kidney biopsies is unclear, and which patients are the best candidates for this route is unknown.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.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.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.