Do platelet function analyzer-100 testing results correlate with bleeding events after percutaneous renal biopsy?
BACKGROUND
Predicting bleeding after percutaneous kidney biopsy (PKB) is difficult. The value of Platelet Function Analyzer-100 (PFA-100) is not studied in this setting.


METHODS
We undertook a prospective study of PFA-100 collagen/epinephrine (CEPI) and collagen/adenosine diphosphate (CADP) closure times among 56 participants (35 males and 21 females) undergoing PKB under real-time ultrasound (US) visualization at a tertiary teaching hospital. We collected data on age, sex, weight, height, blood pressure (BP), serum creatinine, random urine protein/creatinine ratio, electrolytes, PT/PTT, complete blood count, administration of desmopressin acetate and renal biopsy characteristics. Major outcomes were hematoma formation on US, packed red blood (PRBC) transfusions and hematuria. Data were analyzed with SPSS 16.


RESULTS
PFA-CEPI was abnormal in 5 (8.93%) and PFA-CADP abnormal in 8 (14.3%) participants. Post-biopsy hematoma formation on US was detected in 11 (19%) participants, 5 (8.9%) had macroscopic hematuria and 4 (7%) required PRBC transfusion. Bleeding events did not correlate with body mass index, baseline BP or with each other. Hematuria and US-observed hematomas did not appear to be clinically relevant. PRBC transfusions showed a significant association with elevated baseline BUN (p = 0.031), creatinine (p = 0.011) and the number of biopsy passes (p = 0.008). PFA-100 CEPI and CADP did not associate with any of the bleeding complications after PKB (p = NS).


CONCLUSIONS
Measuring PFA-100 is unlikely to add to the care of patients undergoing routine PKB. ClinicalTrials.gov NCT00334204.
Islam
N
N
Department of Family Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
Fulop
T
T
Zsom
L
L
Miller
E
E
Mire
C D
CD
Lebrun
C J
CJ
Schmidt
D W
DW
D000328:Adult; D000368:Aged; D001706:Biopsy / Q000009:adverse effects* / Q000379:methods; D001792:Blood Platelets / Q000502:physiology*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006417:Hematuria / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D010979:Platelet Function Tests / Q000295:instrumentation*; D011379:Prognosis; D011446:Prospective Studies; D015203:Reproducibility of Results; D013997:Time Factors; D014463:Ultrasonography; D055815:Young Adult