Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
Nephrology (Carlton). 2011 Jan;16(1):100-5. doi: 10.1111/j.1440-1797.2010.01369.x.
It has been recognized that renal lesions in patients with diabetes often have other causes of renal damage concomitantly. Renal biopsy is a valuable tool to provide histological evidence. However, the safety in patients with type 2 diabetes receiving renal biopsy is not well evaluated. This study was conducted to monitor the dynamic complications and to evaluate the safety of biopsy in diabetic patients.
A prospective observation was performed on 130 patients with type 2 diabetes and 150 patients not undergoing renal biopsy. The complications were monitored at 4 h, 8 h, 24 h, 48 h and 72 h sequentially after biopsy.
Haematoma was observed in 34 (26.15%) patients with diabetes and 50 (33.33%) in controls (P=0.19). The timing of large haematoma peaked at 4 h. Gross haematuria occurred in 12 (9.23%) diabetic patients and eight (5.33%) controls (P=0.207). It happened mainly within 8 h. Renal pathological diagnosis showed 96 (73.85%) cases with diabetic nephropathy and 34 (26.15%) cases with non-diabetic renal disease.
Renal biopsy in patients with type 2 diabetes is safe. The frequency of complications after renal biopsy in diabetes is no higher than those without diabetes. The complications mostly happened within 8 h, especially within 4 h. Biopsy is also very necessary to rule out other chronic renal diseases in diabetes.
人们已经认识到，糖尿病患者的肾脏病变通常同时存在其他原因引起的肾脏损害。肾活检是提供组织学证据的有价值的工具。然而，接受肾活检的 2 型糖尿病患者的安全性尚未得到很好的评估。本研究旨在监测动态并发症，并评估活检在糖尿病患者中的安全性。
对 130 例 2 型糖尿病患者和 150 例未行肾活检的患者进行前瞻性观察。在活检后 4 h、8 h、24 h、48 h 和 72 h 连续监测并发症。
糖尿病患者中有 34 例（26.15%）出现血肿，对照组有 50 例（33.33%）（P=0.19）。血肿的发生时间在 4 h 时达到高峰。12 例（9.23%）糖尿病患者出现肉眼血尿，对照组有 8 例（5.33%）（P=0.207）。血尿主要发生在 8 h 内。肾脏病理诊断显示 96 例（73.85%）为糖尿病肾病，34 例（26.15%）为非糖尿病肾病。
2 型糖尿病患者的肾活检是安全的。糖尿病患者肾活检后并发症的发生率并不高于无糖尿病患者。并发症大多发生在 8 h 内，尤其是在 4 h 内。活检对于排除糖尿病患者的其他慢性肾脏病也是非常必要的。
