Ultrason Eşliğinde Yapılan Perkütan Nativ Böbrek Biyopsisi Sonrası Kanama Komplikasyonlarını Öngören Faktörler

Ferda BACAKSIZLAR SARI; Dilek GİBYELİ GENEK; Mürşide Gülay ÖRGÜN SÖNMEZ; Melike ERSOY

doi:10.4274/nkmj.galenos.2026.03274

ÖZ

Amaç

Böbrek biyopsisi, böbreğin parankimal hastalıkların tanısında altın standarttır. Böbrek parankim biyopsisi sonrası en sık görülen komplikasyon kanamadır. Bu çalışmanın amacı perkütan nativ böbrek parankim biyopsisi sonrası kanama komplikasyonu riskini artıran hastaya ait faktörleri araştırmaktır.

Gereç ve Yöntem

Perkütan nativ böbrek parankim biyopsisi yapılan toplam 132 hasta çalışmaya dahil edildi. Hasta dosyalarında biyopsi öncesi kaydedilen demografik veriler, yandaş hastalıklar, böbrek biyopsisi endikasyonları, antikoagülan ve/veya antiagregan ilaç kullanımı, kan basıncı, hemoglobin (HGB), trombosit, uluslararası normalleştirilmiş oran (INR), glomerüler filtrasyon hızı, üre, kreatinin değerleri ile biyopsi sonrası kanama komplikasyonu gelişimi, kanamaya müdahale gereksinimi, transfüzyon ihtiyacı ve kanama nedeniyle hastanede kalış süresi retrospektif olarak incelendi.

Bulgular

Biyopsi sonrasında 17 hastada (%12,9) kanama komplikasyonu meydana geldi. Kanaması olan 17 hastanın 5’i (%3,8) majör kanamaydı. Hiçbir hastada embolizasyon veya cerrahi müdahale gerekmedi. İşlem öncesi antiagregan ve/veya antikoagülan ilaç kullanımı, HGB düzeyleri, INR ve kanama komplikasyonu gelişimi arasında istatistiksel olarak anlamlı bir ilişki gözlendi. Kanama komplikasyonu olmayan grupta işlem öncesi ortalama HGB;11,5±2,45 g/dL ve INR; 1,05±0,1 iken, kanama grubunda HGB; 10±1,99 mg/dL ve INR; 1,12±0,12 saptandı (Sırasıyla p=0,013, p=0,009). Kanama saptanan hastalarda antikoagülan ve/veya antiagregan kullanım öyküsü %29,4 iken kanama olmayan grupta %10,4 saptandı (p=0,045).

Sonuç

Çalışmamız, perkütan nativ böbrek parankim biyopsisinin daha düşük kanama riskiyle uygulanabilmesi için biyopsi öncesi özellikle hemogram, INR düzeyleri, antikoagülan ve/veya antiagregan ilaç kullanımı parametreleri açısından yeni güvenli sınırların belirlenmesi, yüksek riskli hasta grubunun tanımlanması ve uygun önlemlerin alınması gerekliliğine dikkat çekmektedir.

Anahtar Kelimeler:

Böbrek biyopsisi, kanama, risk faktörleri

Kaynaklar

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