Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan.
Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan.
Toxins (Basel). 2022 Mar 18;14(3):223. doi: 10.3390/toxins14030223.
A percutaneous renal biopsy is an essential tool for the diagnosis of various renal diseases; however, post-biopsy bleeding is a major complication. Hemocoagulase is a detoxified and purified snake venom enzyme that is widely used to prevent post-procedural bleeding. In this study, we retrospectively analyzed the effect of hemocoagulase on post-renal biopsy bleeding. We included 221 patients who underwent percutaneous renal biopsy between April 2017 and December 2020 and analyzed post-renal biopsy hemoglobin (Hb) decline in patients who were administered a periprocedural hemocoagulase injection. After the renal biopsy, the mean Hb decrease in the entire patient cohort was 0.33 ± 0.84 g/dL. Periprocedural hemocoagulase injection lowered the Hb decline post-renal biopsy (0.50 ± 0.87 vs. 0.23 ± 0.80 g/dL, = 0.0204). The propensity-matched cohort was also adjusted for factors influencing postprocedural bleeding; periprocedural hemocoagulase injection reduced the Hb decline post-renal biopsy (0.56 ± 0.89 vs. 0.17 ± 0.74 g/dL, = 0.006). There were no adverse events (e.g., thrombosis and anaphylactic shock) due to hemocoagulase. Our study demonstrated the beneficial effect of hemocoagulase on post-renal biopsy Hb decline, suggesting its clinical value in preventing post-renal biopsy bleeding.
经皮肾活检是诊断各种肾脏疾病的重要工具；然而，活检后出血是主要并发症。蛇毒血凝酶是一种解毒和纯化的蛇毒酶，广泛用于预防术后出血。在这项研究中，我们回顾性分析了蛇毒血凝酶对肾活检后出血的影响。我们纳入了 2017 年 4 月至 2020 年 12 月期间接受经皮肾活检的 221 例患者，并分析了接受围手术期蛇毒血凝酶注射患者的肾活检后血红蛋白（Hb）下降情况。肾活检后，整个患者队列的平均 Hb 下降值为 0.33±0.84g/dL。围手术期蛇毒血凝酶注射降低了肾活检后的 Hb 下降（0.50±0.87 比 0.23±0.80g/dL， =0.0204）。倾向性匹配队列也调整了影响术后出血的因素；围手术期蛇毒血凝酶注射降低了肾活检后的 Hb 下降（0.56±0.89 比 0.17±0.74g/dL， =0.006）。没有因蛇毒血凝酶引起的不良事件（如血栓形成和过敏性休克）。我们的研究表明蛇毒血凝酶对肾活检后 Hb 下降有有益影响，提示其在预防肾活检后出血方面的临床价值。
