Antiphospholipid Antibodies and Bleeding From Renal Biopsy
Antiphospholipid Antibodies and Bleeding From Renal Biopsy
Jordan N, Chaib A, Sangle S, et al
Arthritis Care Res (Hoboken). 2014;66:725-731
Jordan and colleagues retrospectively evaluated risks for postprocedural bleeding complications in patients who underwent renal biopsy for lupus nephritis. Bleeding occurred in 14.8% of the 215 renal biopsies evaluated. Bleeding complications included perinephric hematomas, and in some cases abdominal bleeding of such severity that nephrectomy was required.
The investigators found that bleeding was most common in patients with concomitant antiphospholipid antibody positivity and lupus. Other factors associated with bleeding complications included elevated creatinine concentration, age older than 40 years, and the presence of thrombotic microangiopathy and intimal fibrosis on biopsy. They were unable to find a significant association between bleeding risk and aspirin use, anticoagulation, or history of hypertension.
They concluded that patients with lupus nephritis and coexisting antiphospholipid syndrome and thrombotic microangiopathy are at higher risk for post-renal biopsy bleeding complications.
Association of Thrombotic Microangiopathy and Intimal Hyperplasia With Bleeding Post-Renal Biopsy in Antiphospholipid Antibody-Positive Patients
Jordan N, Chaib A, Sangle S, et al
Arthritis Care Res (Hoboken). 2014;66:725-731
Study Summary
Jordan and colleagues retrospectively evaluated risks for postprocedural bleeding complications in patients who underwent renal biopsy for lupus nephritis. Bleeding occurred in 14.8% of the 215 renal biopsies evaluated. Bleeding complications included perinephric hematomas, and in some cases abdominal bleeding of such severity that nephrectomy was required.
The investigators found that bleeding was most common in patients with concomitant antiphospholipid antibody positivity and lupus. Other factors associated with bleeding complications included elevated creatinine concentration, age older than 40 years, and the presence of thrombotic microangiopathy and intimal fibrosis on biopsy. They were unable to find a significant association between bleeding risk and aspirin use, anticoagulation, or history of hypertension.
They concluded that patients with lupus nephritis and coexisting antiphospholipid syndrome and thrombotic microangiopathy are at higher risk for post-renal biopsy bleeding complications.
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