Effect of Hemocoagulase on the Prevention of Bleeding after Percutaneous Renal Biopsy

Abstract

A percutaneous renal biopsy is an essential tool for the diagnosis of various renal diseases; however, post-biopsy bleeding is a major complication. Hemocoagulase is a detoxified and purified snake venom enzyme that is widely used to prevent post-procedural bleeding. In this study, we retrospectively analyzed the effect of hemocoagulase on post-renal biopsy bleeding. We included 221 patients who underwent percutaneous renal biopsy between April 2017 and December 2020 and analyzed post-renal biopsy hemoglobin (Hb) decline in patients who were administered a periprocedural hemocoagulase injection. After the renal biopsy, the mean Hb decrease in the entire patient cohort was 0.33 ± 0.84 g/dL. Periprocedural hemocoagulase injection lowered the Hb decline post-renal biopsy (0.50 ± 0.87 vs. 0.23 ± 0.80 g/dL, p = 0.0204). The propensity-matched cohort was also adjusted for factors influencing postprocedural bleeding; periprocedural hemocoagulase injection reduced the Hb decline post-renal biopsy (0.56 ± 0.89 vs. 0.17 ± 0.74 g/dL, p = 0.006). There were no adverse events (e.g., thrombosis and anaphylactic shock) due to hemocoagulase. Our study demonstrated the beneficial effect of hemocoagulase on post-renal biopsy Hb decline, suggesting its clinical value in preventing post-renal biopsy bleeding.

Effect of hemocoagulase on the coagulation parameters, blood transfusion volume and bleeding volume of patients with severe traumatic fractures

“…Previous studies [19,20] have demonstrated that the application of hemocoagulase during hepatobiliary surgery can effectively reduce intraoperative bleeding volume without affecting the coagulation functions of patients. Furthermore, other studies [21,22] have shown that injection of hemocoagulase into rabbits accelerated blood coagulation without affecting platelet concentration. A study by Nascimento da Costa et al [23] found that hemocoagulase therapy does not confer the risk of deep vein thrombosis in the lower limb and is clinically safe and highly reliable in elderly patients.…”

Factors Associated with Glomerular Yield in Percutaneous Kidney Biopsy

“…A nephrologist performed kidney biopsies using a 16 G needle under ultrasonic guidance. Details of the procedure used in our hospital have been previously described [ 9 , 10 ]. The core samples were divided for assessment using light microscopy (LM), immunofluorescence microscopy (IF), and electron microscopy (EM).…”

Bioactive Hydrogels with Pro‐coagulation Effect for Hemostasis†

“…Hemocoagulase, also known as batroxobin or reptilase, is a widely utilized clinical hemostasis agent for surgical hemostasis [ 135‐138 ] and bleeding prevention. [ 139‐140 ] It promotes platelet aggregation at the site of vascular damage, hydrolyzes the αA chain of fibrinogen, and converts fibrinogen into fibrin, thereby facilitating hemostasis. [ 141‐142 ] Kumar et al .…”