The practice of selecting replacement fluid for therapeutic plasma exchange (TPE) after percutaneous kidney biopsy is variable and often depends on the number of days after biopsy that the apheresis treatment plan is initiated. It has been previously reported that most centers utilize plasma for at least part of replacement fluid for TPE after kidney biopsy, and quite often for many days. In this retrospective study, 100 consecutive patients who underwent percutaneous kidney biopsy and had TPE initiated 2 days after biopsy were analyzed. Half of these patients had exclusively albumin replacement fluid, and the other half had replacement fluid with both albumin and plasma. Rates for bleeding at the kidney biopsy site were identical and occurred in 1 patient (2%) in each cohort. Future studies assessing bleeding risk in this patient population receiving TPE should concentrate on the duration within 1 day after percutaneous kidney biopsy.
Raval et al. (Wed,) studied this question.