Safety and effectiveness of transjugular renal biopsy for systemic lupus erythematosus and antiphospholipid antibody syndrome patients taking antithrombotics
| Autor: | Micheline Pha, Zahir Amoura, Marc Pineton de Chambrun, Philippe Rouvier, Pierre Hausfater, Du Boutin-Le Thi Huong, Neila Benameur, Philippe Cluzel, Makoto Miyara, Maud Cazenave, Julien Haroche, Fleur Cohen-Aubart, Hubert Nielly, Isabelle Brocheriou, Alexis Mathian, Hassan Izzedine, Miguel Hie |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Biopsy medicine.medical_treatment 030232 urology & nephrology Lupus nephritis Gastroenterology Nephropathy 03 medical and health sciences Postoperative Complications 0302 clinical medicine Fibrinolytic Agents Antiphospholipid syndrome Internal medicine medicine Humans Lupus Erythematosus Systemic Retrospective Studies 030203 arthritis & rheumatology Transplantation medicine.diagnostic_test business.industry Antiphospholipid Syndrome Prognosis medicine.disease Lupus Nephritis Nephrectomy Nephrology Female Renal biopsy Jugular Veins Complication business Fibrinolytic agent |
| Zdroj: | Nephrology Dialysis Transplantation. 35:1721-1729 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/gfz085 |
| Popis: | BackgroundRenal biopsy is the cornerstone of systemic lupus erythematosus (SLE) nephritis and antiphospholipid syndrome (APS) nephropathy management. However, transcutaneous renal biopsy (TCRB) is hampered by the antithrombotic treatment frequently prescribed for those diseases. Transjugular renal biopsy (TJRB) offers an attractive alternative for patients at increased risk of bleeding. The primary objective of the study was to describe the safety profile and diagnostic performance of TJRB in SLE and APS patients.MethodsAll SLE and/or APS patients who underwent a renal biopsy in our department (between January 2004 and October 2016) were retrospectively reviewed. Major complications were death, haemostasis nephrectomy, renal artery embolization, red blood cell transfusion, sepsis and vascular thrombosis; macroscopic haematuria, symptomatic perirenal/retroperitoneal bleeding and renal arteriovenous fistula without artery embolization were considered as minor complications.ResultsTwo hundred and fifty-six TJRBs—119 without antithrombotics (untreated), 69 under aspirin and 68 on anticoagulants and 54 TCRBs without antithrombotics—were analysed. Their major and minor complication rates, respectively, did not differ significantly for the four groups: 0 and 8% for untreated TJRBs, 1 and 6% for aspirin-treated, 6 and 10% for anticoagulant-treated and 2 and 2% for TCRBs. The number of glomeruli sampled and the biopsy contribution to establishing a histological diagnosis was similar for the four groups.ConclusionsTJRBs obtained from SLE and APS patients taking antithrombotics had diagnostic yields and safety profiles similar to those of untreated TCRBs. Thus, TJRB should be considered for SLE and APS patients at risk of bleeding. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|