During the treatment process, many patients often encounter doctors recommending renal puncture. When they hear these three words, they shudder, and they will inevitably feel fear and worry. The kidney is already sick. Kidney puncture, can the body eat it? Is there any danger? Will there be sequelae? Even if I do it once, I can barely accept it. Sometimes I do it many times. I believe that every kidney friend will be extremely resistant: Is it really necessary to do it? Can’t you do it?
First of all, as a doctor who has been practicing medicine for more than 40 years, I admit that kidney biopsy has its drawbacks. It is an invasive examination, not non-invasive. Patients It is necessary to bear certain risks such as bleeding and hematoma, and a very small number of patients may also experience severe bleeding, which may even be life-threatening. And it usually requires hospitalization, costing thousands of dollars. Whether it is physical, psychological, time-consuming or economic loss, it is not a small test. Can’t the doctor treat it directly without wearing it?
Yes. The etiology of these 3 cases can be clarified without puncture:
1. Nephrotic syndrome caused by malignant tumor can be relieved after treatment of tumor nephropathy.
2. Diabetes has damaged the kidneys for many years, from microalbuminuria to significant proteinuria.
3. Kidney damage caused by years of high blood pressure.
These three causes are relatively clear, and doctors can treat them according to experience. In addition, these 8 types of patients are not suitable for puncture:
1. Those with obvious bleeding tendency.
2. Patients with congenital solitary kidney.
3. Patients with severe renal insufficiency on one side.
4. Patients with renal hematoma, tumor, cyst, abscess or infection, hydronephrosis.
5. Mental patients may not be able to cooperate with the operator.
6. Hypertensive patients with poor blood pressure control.
7. Patients with thin renal cortex.
8. Patients with hypercoagulation and severe anemia
However, in many cases, renal puncture is required to help doctors clarify the pathology Or judge the severity of the condition, such as the following 5 situations:
1. Primary nephrotic syndrome, treat first, and perform renal puncture when regular hormone treatment fails for 8 weeks.
2. For patients with rapid renal function decline, early renal biopsy is required to determine the pathological type of renal damage.
3. For acute nephritic syndrome, kidney biopsy should be done early to find the morphology and degree of inflammation and immune deposits, which is very helpful for diagnosis and treatment.
4. Lupus nephritis, nephrogenic hypertension and other hereditary or secondary nephropathy, when the clinical suspicion cannot be confirmed, the clinical diagnosis has been confirmed, but the renal pathological data can guide the treatment Or renal puncture should be done when it is important to judge the prognosis.
5. Acute renal failure: When the condition is severe and the etiology cannot be determined by clinical and laboratory tests, timely puncture should be performed.
We have a clear idea of which situations require renal biopsy, which situations do not, and which types of patients cannot undergo renal biopsy. In this way, unnecessary examinations will not be done, which will hurt the body and cost money, and the loss is not small; it will not cause misdiagnosis and mistreatment because of not doing kidney puncture, causing doctors to continue to trial and error.
Kidney friends, don’t worry, as long as you are in a regular hospital, under the premise of strictly grasping the surgical indications and strictly standardizing the operation, renal puncture is still quite safe, and complications may occur The possibility is very small.