Néphrologie-Hypertension, Dialyses, Transplantation rénale, Hôpital Bretonneau, CHU Tours.
EA4245, University of Tours, Tours.
Curr Opin Nephrol Hypertens. 2021 Nov 1;30(6):555-558. doi: 10.1097/MNH.0000000000000736.
To assess the risk of complications associated with native kidney biopsies. This review will highlight recent advances on the risk factors for major bleeding and risk management in patients with native kidney biopsy.
Recent studies provided new important data regarding the individualization of the risk of bleeding after kidney biopsy. A new bleeding risk score was proposed as a risk stratification tool, useful for shared decision making and procedure choice.
The risk of complications is low (<1%) in most patients but varies widely. Risk factors include Charlson index, frailty index, female gender, dyslipidemia, anemia, thrombocytopenia, cancer, abnormal kidney function, glomerular disease, autoimmune disease, vasculitis, hematologic disease, and thrombotic microangiopathy. A new bleeding score can help physicians and patients to assess the risk of bleeding enabling informed consent, and decide to perform it or not, and to prefer transjugular vs percutaneous route.
评估与肾活检相关的并发症风险。本文将重点介绍肾活检患者发生大出血的风险因素及风险管理的最新进展。
最近的研究提供了有关肾活检后出血风险个体化的新重要数据。提出了一种新的出血风险评分作为风险分层工具，有助于共同决策和选择操作。
大多数患者并发症的风险较低（<1%），但差异很大。危险因素包括Charlson 指数、衰弱指数、女性、血脂异常、贫血、血小板减少症、癌症、肾功能异常、肾小球疾病、自身免疫性疾病、血管炎、血液病和血栓性微血管病。新的出血评分可以帮助医生和患者评估出血风险，从而进行知情同意，并决定是否进行肾活检，以及选择经颈静脉入路还是经皮入路。
