González-Michaca L, Chew-Wong A, Soltero L, Gamba G, Correa-Rotter R
Departamento de Nefrología y Metabolismo Mineral, Instituto Nacional de la Nutrición Salvador Zubirán.
Rev Invest Clin. 2000 Mar-Apr;52(2):125-31.
Percutaneous renal biopsy is an invasive procedure that can result in major and minor complications. The objective of this study was to know the frequency and type of complications in relation with this procedure, as well as the efficacy to obtain enough material for diagnosis.
Retrospective study. We review the charts of patients to whom a percutaneous renal biopsy of native kidneys was done between January 1970 and March 1996. The following data were obtained: age, gender, clinical and histopathological diagnosis, complications associated with the procedure (minor: hematuria, local infections, hematoma; major: transfusions, severe infections, surgery, nephrectomy, arteriography, embolism and death).
We analyzed 1,005 renal biopsies in 840 patients, mean age 37.7 +/- 13.1 years, 67% female. There were no complications in 88.8% (893 biopsies), minor complications in 8.65% (87 biopsies) and only in 2.4% of the procedures major complications. We divided the cases in two groups: percutaneous renal biopsy without complications (n = 893, 89%) and with complications (n = 112, 11%). The most frequent complications were hematuria (91 cases, 9.1%) and perirenal hematoma (29 cases, 2.7%). In these cases transfusion was required in 2.4% (26). Infectious complications were: urosepsis in 7 cases (0.7%), bacteremia, sepsis and perirenal abscesses (1 case each, 0.1%). One patient died because of multiple complications (0.1%). We observed greater risk of major complications on patients in those who biopsy was done because of acute renal failure (OR 4.03, p < 0.003).
In our experience percutaneous renal biopsy is a low risk procedure. Most complications are minor and without clinical repercussion. There must be a strict selection criteria of the patients to whom percutaneous renal biopsy is going to be done because of the risk of severe complications.
经皮肾活检是一种侵入性操作,可能导致严重和轻微并发症。本研究的目的是了解与该操作相关的并发症的发生率和类型,以及获取足够诊断材料的有效性。
回顾性研究。我们查阅了1970年1月至1996年3月期间接受经皮肾活检的患者病历。获取了以下数据:年龄、性别、临床和组织病理学诊断、与操作相关的并发症(轻微:血尿、局部感染、血肿;严重:输血、严重感染、手术、肾切除术、血管造影、栓塞和死亡)。
我们分析了840例患者的1005次肾活检,平均年龄37.7±13.1岁,67%为女性。88.8%(893次活检)无并发症,8.65%(87次活检)有轻微并发症,仅2.4%的操作有严重并发症。我们将病例分为两组:无并发症的经皮肾活检(n = 893,89%)和有并发症的经皮肾活检(n = 112,11%)。最常见的并发症是血尿(91例,9.1%)和肾周血肿(29例,2.7%)。在这些病例中,2.4%(26例)需要输血。感染性并发症包括:7例尿脓毒症(0.7%)、菌血症、脓毒症和肾周脓肿各1例(0.1%)。1例患者因多种并发症死亡(0.1%)。我们观察到因急性肾衰竭进行活检的患者发生严重并发症的风险更高(OR 4.03,p < 0.003)。
根据我们的经验,经皮肾活检是一种低风险操作。大多数并发症为轻微并发症,无临床影响。由于存在严重并发症的风险,必须对拟进行经皮肾活检的患者有严格的选择标准。