Schow D A, Vinson R K, Morrisseau P M
Department of Urology, Medical Center Hospital of Vermont, Burlington.
J Urol. 1992 May;147(5):1235-7. doi: 10.1016/s0022-5347(17)37526-2.
We recently were presented with a patient from the nephrology service, with the request to perform open renal biopsy because of a solitary functioning kidney. We performed the open biopsy and the patient subsequently had a wound infection, leading us to question the recommendation in the literature stating that a solitary kidney is an absolute contraindication for percutaneous renal biopsy. In a review of the literature from 1951 to 1990, a total of 19,459 percutaneous renal biopsies has been reported with an overall complication rate of 2.1 to 10.8%, the majority (90%) of which did not require definitive treatment. Only 13 nephrectomies (0.06%) were required secondary to complications. The overall mortality rate was 0.08%. We reviewed 157 percutaneous renal biopsies done at this institution from 1985 to 1990 with a minor complication rate of only 5% and no major complications or loss of kidney function. The mortality rate was 0. Based on our study and a review of the literature, both showing an extremely small percentage of permanent loss of kidney function or mortality, we propose that a solitary kidney no longer be recommended as an absolute contraindication to percutaneous renal biopsy.
最近，肾内科转来一位患者，因其仅有一个功能肾，要求进行开放性肾活检。我们进行了开放性活检，随后患者出现伤口感染，这使我们对文献中的建议产生质疑，文献称单肾是经皮肾活检的绝对禁忌证。回顾1951年至1990年的文献，共报道了19459例经皮肾活检，总体并发症发生率为2.1%至10.8%，其中大多数（90%）无需确定性治疗。仅13例（0.06%）因并发症需要肾切除。总体死亡率为0.08%。我们回顾了1985年至1990年在本机构进行的157例经皮肾活检，轻微并发症发生率仅为5%，无重大并发症或肾功能丧失。死亡率为0。基于我们的研究和文献回顾，两者均显示肾功能永久性丧失或死亡的比例极低，我们建议不再将单肾作为经皮肾活检的绝对禁忌证。
