Introduction: Percutaneous renal biopsy (PRB) is the gold standard for the diagnosis of most renal diseases. It is a safe and effective modality for the collection of renal tissue. However, many safety measures are no...Introduction: Percutaneous renal biopsy (PRB) is the gold standard for the diagnosis of most renal diseases. It is a safe and effective modality for the collection of renal tissue. However, many safety measures are not based on sufficient evidence and therefore vary considerably from a center to another. The aim of this work is to determine the rate of bleeding complications, to identify the risk factors for these complications, and to clarify the post renal biopsy prognosis. Materials and Methods: We performed a single-center retrospective observational study in the nephrology department at the University Hospital of Fez, including all patients who underwent percutaneous renal biopsy on native kidney between January 2018 and December 2019. Results: Overall, 157 biopsies were performed. Deglobulization was present in 20.4% (40) of patients, the mean age of patients was 41.57 ± 16.11 years [16.78]. The sex ratio M/F: 1.22. Diabetes mellitus was present in four cases (11.1%), arterial hypertension was present in four cases (11.1%). On clinical examination, systolic hypertension was found in 45.7%, diastolic hypertension in 45%, antihypertensive therapy was initiated in all patients with hypertension before. Hyperuremia was present in 29 patients (80.6%), renal failure was present in 77.8%. Anemia was present in 55.6%, thrombocytopenia in six cases (16.7%). Radiologically, the size of the kidneys was reduced in 5 patients (17.2%), differentiation was limited in 5 patients (17.2%). Major complications occurred in 3.8% (6/157). These six patients had a lumbar pain and required blood transfusions. A radiological embolization procedure was indicated in only one patient. Minor complications were seen in 21.6% (34/157). The diagnoses that were retained in patients with deglobulization were: Lupus in 34.71%, pauci-immune vasculitis in 13.79%, membranous glomerulonephritis in 10.34%, focal and segmental hyalinosis in 10.34%, membrano-proliferative glomerulonephritis in 10.34%. In univariate and multivariate analysis, the major risk factors for deglobulization found in our patients were: hyperuremia 80.6% (p: 0.017), acute renal failure 77.8% (p: 0.04), acute hemodialysis 24.7% (p: 0.02), hyperphosphatemia 63.6% (0.04). Conclusion: Renal biopsies are an overall safe procedure with rare major complications. Post-renal biopsy deglobulization is common. Routine post-biopsy ultrasound may not be necessary. Renal biopsies can be performed safely if risk factors are controlled, such as renal failure, hyperuremia, hyperphosphatemia, hemodialysis patients and a diagnosis of lupus nephropathy.展开更多
目的观察肾活检术前镇静药物对缓解患者疼痛感及紧张程度、预防术中高血压、改善术后睡眠状况的效果。方法2005年6月至8月,将符合肾活检指征的102例肾脏病患者随机分成两组,治疗组(n=52)在肾活检术前晚使用“艾司唑仑”及术前15 m in使...目的观察肾活检术前镇静药物对缓解患者疼痛感及紧张程度、预防术中高血压、改善术后睡眠状况的效果。方法2005年6月至8月,将符合肾活检指征的102例肾脏病患者随机分成两组,治疗组(n=52)在肾活检术前晚使用“艾司唑仑”及术前15 m in使用“咪达唑仑”,对照组(n=50)术前不使用任何镇静药物;分别观察两组患者术前、术中和术后的心理评分,术中血压、疼痛感、紧张程度及术中配合情况,术后睡眠及发生出血并发症等情况。结果治疗组患者术前心理评分高于对照组(P<0.05),术中血压升高比例、高度紧张比例、重度疼痛感患者比例均低于对照组(P<0.05),术中配合程度及术后入睡休息情况也明显优于对照组(P<0.01);两组患者发生术后出血并发症的情况无明显差异。结论对拟施肾活检术的患者在术前晚使用“艾司唑仑”及术前15 m in使用“咪达唑仑”能降低患者术中紧张度及疼痛感,改善术中配合情况及术后入睡休息情况。展开更多
文摘Introduction: Percutaneous renal biopsy (PRB) is the gold standard for the diagnosis of most renal diseases. It is a safe and effective modality for the collection of renal tissue. However, many safety measures are not based on sufficient evidence and therefore vary considerably from a center to another. The aim of this work is to determine the rate of bleeding complications, to identify the risk factors for these complications, and to clarify the post renal biopsy prognosis. Materials and Methods: We performed a single-center retrospective observational study in the nephrology department at the University Hospital of Fez, including all patients who underwent percutaneous renal biopsy on native kidney between January 2018 and December 2019. Results: Overall, 157 biopsies were performed. Deglobulization was present in 20.4% (40) of patients, the mean age of patients was 41.57 ± 16.11 years [16.78]. The sex ratio M/F: 1.22. Diabetes mellitus was present in four cases (11.1%), arterial hypertension was present in four cases (11.1%). On clinical examination, systolic hypertension was found in 45.7%, diastolic hypertension in 45%, antihypertensive therapy was initiated in all patients with hypertension before. Hyperuremia was present in 29 patients (80.6%), renal failure was present in 77.8%. Anemia was present in 55.6%, thrombocytopenia in six cases (16.7%). Radiologically, the size of the kidneys was reduced in 5 patients (17.2%), differentiation was limited in 5 patients (17.2%). Major complications occurred in 3.8% (6/157). These six patients had a lumbar pain and required blood transfusions. A radiological embolization procedure was indicated in only one patient. Minor complications were seen in 21.6% (34/157). The diagnoses that were retained in patients with deglobulization were: Lupus in 34.71%, pauci-immune vasculitis in 13.79%, membranous glomerulonephritis in 10.34%, focal and segmental hyalinosis in 10.34%, membrano-proliferative glomerulonephritis in 10.34%. In univariate and multivariate analysis, the major risk factors for deglobulization found in our patients were: hyperuremia 80.6% (p: 0.017), acute renal failure 77.8% (p: 0.04), acute hemodialysis 24.7% (p: 0.02), hyperphosphatemia 63.6% (0.04). Conclusion: Renal biopsies are an overall safe procedure with rare major complications. Post-renal biopsy deglobulization is common. Routine post-biopsy ultrasound may not be necessary. Renal biopsies can be performed safely if risk factors are controlled, such as renal failure, hyperuremia, hyperphosphatemia, hemodialysis patients and a diagnosis of lupus nephropathy.
文摘目的观察肾活检术前镇静药物对缓解患者疼痛感及紧张程度、预防术中高血压、改善术后睡眠状况的效果。方法2005年6月至8月,将符合肾活检指征的102例肾脏病患者随机分成两组,治疗组(n=52)在肾活检术前晚使用“艾司唑仑”及术前15 m in使用“咪达唑仑”,对照组(n=50)术前不使用任何镇静药物;分别观察两组患者术前、术中和术后的心理评分,术中血压、疼痛感、紧张程度及术中配合情况,术后睡眠及发生出血并发症等情况。结果治疗组患者术前心理评分高于对照组(P<0.05),术中血压升高比例、高度紧张比例、重度疼痛感患者比例均低于对照组(P<0.05),术中配合程度及术后入睡休息情况也明显优于对照组(P<0.01);两组患者发生术后出血并发症的情况无明显差异。结论对拟施肾活检术的患者在术前晚使用“艾司唑仑”及术前15 m in使用“咪达唑仑”能降低患者术中紧张度及疼痛感,改善术中配合情况及术后入睡休息情况。
