Percutaneous renal aspiration biopsy I. What is meant by percutaneous renal aspiration biopsy? Percutaneous renal aspiration biopsy is usually called renal puncture or renal biopsy. A fine puncture instrument is used to puncture the kidney through the skin and remove a very small amount of kidney tissue for pathological examination, usually a puncture needle of about 1.5 mm in diameter is used to remove about 1 cm of kidney tissue for pathological examination. Under what circumstances is a kidney biopsy necessary? When patients have proteinuria (urine routine examination, quantitative urine protein examination, etc.), glomerular (polymorphic) hematuria (urine routine examination and phase difference microscopy), unexplained acute and chronic renal failure and others, etc. About 30%~50% of the patients with kidney disease need kidney biopsy. Third, why should kidney biopsy be done Because of the wide variety of kidney diseases, complex etiology and pathogenesis, the clinical manifestations of many kidney diseases are not completely consistent with the histological changes of the kidney. Non-invasive examinations such as blood tests, urine and imaging currently performed clinically cannot provide early diagnosis and accurate assessment of renal function and pathological changes, which makes the determination of treatment plan very difficult. The main purpose of kidney biopsy is not only to clarify the diagnosis, but more importantly to guide the determination of treatment plan. Since there are more side effects of the effective drugs for kidney disease, such as glucocorticoids and immunosuppressants, patients need to choose whether to use and which drugs to use, other than helping to judge the prognosis and guiding the diet and physical exercise of patients. Fourth, is kidney biopsy safe? With the application of ultrasound, especially kidney biopsy under real-time guidance with ultrasound puncture probe, it is extremely safe, and after excluding contraindications, it can be said to be 99.9% safe, with only 1 in 10,000 or 1 in 100,000 having serious complications. The kidney biopsy is only a very small damage to the kidney, no damage. There will be no after-effects. V. Can kidney biopsy pathological examination fully diagnose kidney disease? Normal people have two kidneys, and kidney biopsy usually punctures only one side of the kidney, which is very accurate for glomerular diseases, tubulointerstitial diseases and some systemic diseases with kidney damage. Because these diseases all uniformly lead to renal lesions on both sides, a more accurate diagnosis can be made if the kidney tissue of more than 10 glomeruli is punctured. What are the precautions before and after kidney biopsy? Before surgery, cooperate with the doctor to do all the examinations, mainly to clarify the indications, contraindications and etiology, relax the mind, learn to breathe and hold the breath, lie down to urinate and defecate. After the operation, you should stay in bed for 24 hours, especially for the first 6-8 hours after the operation, and then you can eat, turn over, urinate and defecate with the assistance of others. After the operation, there are also blood pressure and pulse tests, and routine urine tests, etc. You can drink more water on the 2nd day after surgery, get out of bed after 24 hours, move slightly on the 3rd day after surgery, move lightly after 7 days after surgery, and can move normally on the 14th day after surgery. VII. What are the complications of kidney biopsy? 1, hematuria: about 60 to 80% of patients have varying degrees of microscopic hematuria, and some patients may have carnal hematuria. 2, perirenal hematoma: less common, absolute bed rest within 24 hours after renal biopsy, if the patient cannot tolerate it, the importance of absolute bed rest and the possible complications of strenuous activity should be explained clearly to the patient in time. 3, low back pain and lumbar discomfort: less common, most patients have mild ipsilateral low back pain or lumbar discomfort, usually lasting about 1 week. 4, abdominal pain and distension: less common, individual patients have abdominal pain after renal biopsy, lasting 1-7 days, a few patients may have pressure pain and rebound pain. 5.Fever: less common, patients with perirenal hematoma have moderate fever due to the absorption of the hematoma. 6. Other: rare complications such as infection and hemorrhage.