Objective  To evaluate the risk of hemorrhagic complication after renal biopsy in patients with prolonged APTT and normal thromboelastography (TEG).

Methods  A total of 327 patients underwent ultrasound-guided percutaneous renal biopsy from January 2021 to July 2022. According to whether or not APTT was prolonged, they were divided into two groups of normal APTT (n=272) and prolonged APTT and normal TEG (n=55). Overt hemorrhagic complications were compared between two groups and subgroups (APTT prolonged <5 s and APTT prolonged >5 s). Also TEG parameters and overt hemorrhagic complication of patients with TEG data in two groups were compared and the correlation was examined between TEG and coagulation.

Results  No significant inter-group difference existed in baseline characteristics (P>0.05). The incidence of overt hemorrhagic complication was 3.68% in normal APTT group and 5.45% in prolonged APTT and normal TEG group. No significant inter-group difference existed in the incidence of overt hemorrhagic complication (P>0.05). The risk of hemorrhagic complication was not elevated in prolonged APTT and normal TEG group. Furthermore, no significant difference existed in the incidence of overt hemorrhagic complication between subgroups of APTT prolonged <5 s and APTT prolonged >5 s. Analysis of patients with TEG data revealed no significant inter-group differences in TEG parameters or the incidence of overt hemorrhage. Also weak correlation existed between reaction time and APTT.

Conclusions  APTT can not accurately predict the hemorrhagic risk after biopsy. And renal biopsy is feasible for patients with prolonged APTT and normal TEG.