A Universal Bleeding Risk Score in Native and Allograft Kidney Biopsies: A French Nationwide Cohort Study

The risk of bleeding after percutaneous biopsy in kidney transplant recipients is usually low but may vary. A pre-procedure bleeding risk score in this population is lacking. We assessed the major bleeding rate (transfusion, angiographic intervention, nephrectomy, hemorrhage/hematoma) at 8 days in 2...

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Bibliographic Details
Published in:Journal of clinical medicine 2023-05, Vol.12 (10), p.3527
Main Authors: Kaczmarek, Mathieu, Halimi, Jean-Michel, de Fréminville, Jean-Baptiste, Gatault, Philippe, Gueguen, Juliette, Goin, Nicolas, Longuet, Hélène, Barbet, Christelle, Bisson, Arnaud, Sautenet, Bénédicte, Herbert, Julien, Buchler, Matthias, Fauchier, Laurent
Format: Article
Language:English
Subjects:
Anemia
Biopsy
Blood transfusions
Cardiovascular disease
Clinical medicine
Cohort analysis
Confidence intervals
Diabetes
Health aspects
Heart failure
Hematoma
Hemorrhage
Hospitals
Hypertension
Intervention
Kidney transplants
Kidneys
Organ transplant recipients
Patients
Population
Prevention
Risk factors
Transplantation
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Summary:The risk of bleeding after percutaneous biopsy in kidney transplant recipients is usually low but may vary. A pre-procedure bleeding risk score in this population is lacking. We assessed the major bleeding rate (transfusion, angiographic intervention, nephrectomy, hemorrhage/hematoma) at 8 days in 28,034 kidney transplant recipients with a kidney biopsy during the 2010-2019 period in France and compared them to 55,026 patients with a native kidney biopsy as controls. The rate of major bleeding was low (angiographic intervention: 0.2%, hemorrhage/hematoma: 0.4%, nephrectomy: 0.02%, blood transfusion: 4.0%). A new bleeding risk score was developed (anemia = 1, female gender = 1, heart failure = 1, acute kidney failure = 2 points). The rate of bleeding varied: 1.6%, 2.9%, 3.7%, 6.0%, 8.0%, and 9.2% for scores 0 to 5, respectively, in kidney transplant recipients. The ROC AUC was 0.649 (0.634-0.664) in kidney transplant recipients and 0.755 (0.746-0.763) in patients who had a native kidney biopsy (rate of bleeding: from 1.2% for score = 0 to 19.2% for score = 5). The risk of major bleeding is low in most patients but indeed variable. A new universal risk score can be helpful to guide the decision concerning kidney biopsy and the choice of inpatient vs. outpatient procedure both in native and allograft kidney recipients.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12103527