Is the bleeding time predictive of bleeding prior to a percutaneous renal biopsy?
The bleeding time is used by many nephrologists to predict risk of hemorrhage before percutaneous kidney biopsy. Developed in 1910, the bleeding time is a nonspecific test that may be prolonged in multiple disease states. When accompanied by a platelet count, hematocrit, and a thorough investigation of family or personal history of bleeding, the bleeding time is the best predictor of hemorrhagic risk in patients with kidney disease. Because there is a small but significant risk of bleeding with percutaneous kidney biopsy, a prolonged bleeding time should be treated with 1-deamino-8-D-arginine vasopressin, cryoprecipitate, estrogens, or dialysis as indicated before biopsy. Treating all patients with 1-deamino-8-D-arginine vasopressin without checking bleeding times may be cost-ineffective when compared with treating only those patients with prolonged bleeding times.
Mattix
H
H
Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA.
Singh
A K
AK
D001706:Biopsy / Q000009:adverse effects*; D001760:Bleeding Time; D006801:Humans; D007668:Kidney / Q000473:pathology*; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011300:Preoperative Care