Renal puncture biopsy is a minimally invasive pathological diagnostic technique with B-ultrasound-guided percutaneous renal puncture that is safe and minimally invasive. The technique has a wide range of indications, few contraindications and few side effects.
Indications.
1.Acute glomerulonephritis: if no remission is seen after 2-3 months of treatment, renal puncture pathological examination should be done.
2, acute glomerulonephritis: pathological examination is very important to confirm the diagnosis of the disease and the development of treatment plans, the proposed diagnosis of the disease immediately do renal biopsy, the sooner the better.
3, primary nephrotic syndrome: can be caused by at least 5 different pathological types of glomerular disease, their treatment plans and efficacy are also very different, it is necessary to perform renal puncture examination.
4, chronic glomerulonephritis: renal puncture biopsy can determine the type of nephritis pathology and understand the severity of the disease.
5, occult glomerulonephritis: those who present with asymptomatic proteinuria and/or hematuria need to undergo renal puncture pathology when identification is difficult.
6, secondary glomerular diseases: such as lupus nephritis, purpura nephritis, etc., renal pathological material is valuable to clarify the diagnosis and typing of the disease and assess the condition, and renal puncture should be performed.
7, hereditary glomerulonephritis: Alport syndrome and familial hematuria, renal puncture pathological examination is of great significance for diagnosis.
8, hypertensive nephropathy, diabetic nephropathy: renal puncture pathological examination should still be performed when the clinical diagnosis is unclear.
9, tubulointerstitial nephritis: acute and chronic tubulointerstitial nephritis, confirming the diagnosis mainly relies on renal puncture pathology.
10, acute renal failure: acute renal failure of unclear etiology.
Contraindications.
1, obvious bleeding dump.
2, severe hypertension, can not be stable control of 160/100mmHg or less.
3, chronic renal failure kidney has been atrophied.
4, Isolated kidney, horseshoe kidney, renal tumor should not be punctured.
5, active pyelonephritis, renal tuberculosis, hydronephrosis (pus) perirenal abscess should not be punctured.
6, late pregnancy, high obesity, high ascites are relative contraindications to renal puncture.
Complications.
1, hematuria, the incidence of carnal hematuria after renal puncture 3%-5%, turn clear within 1-3 days.
2, perirenal hematoma, incidence 1%-2% mostly small hematoma.
3, arteriovenous fistula, seen in very rare patients with chronic renal failure and hypertension.