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对原发性肾脏经皮肾活检相关并发症的前瞻性研究:某中心的经验

Prospective study of the complications associated with percutaneous renal biopsy of native kidneys: experience in a centre.

作者信息

Pendón-Ruiz de Mier M Victoria, Espinosa-Hernández Mario, Rodelo-Haad Cristian, Esquivias-de Motta Elvira, Gómez-Carrasco José, Ortega Rosa, Aljama Pedro

出版信息

Nefrologia. 2014 May 21;34(3):383-7. doi: 10.3265/Nefrologia.pre2014.Jan.12323. Epub 2014 Apr 10.

Abstract

BACKGROUND

Percutaneous renal biopsy (PRB) is a key invasive technique in the study of kidney disease and it is associated with considerable morbidity. Retrospective studies have shown minor complications in 10%-20% and major complications in 1.2%-6.6% of cases. However, this aspect has not been studied prospectively.

OBJECTIVE

The aim of our study was to prospectively assess complications related to PRB in the native kidney.

METHODS

From January 2009 to May 2013, we prospectively analysed PRB performed by nephrologists in native kidneys under ultrasound guidance. We analysed clinical and laboratory variables. We defined minor complications as the decrease in haemoglobin (Hb) of more than 1g/dL and major complications as the need for a transfusion or invasive technique.

RESULTS

241 PRB were performed over this period. The mean patient age was 49 years (±17), the majority (56%) were male and 58.1% had high blood pressure. In 51% of cases, we carried out 2 punctures. There were minor complications in 46 patients (19.1%) and major complications in 9 patients (3.7%). In the univariate analysis, pre-PRB Hb was 10.3g/dL (±1.3) in patients with major complications and 12.3g/dL (±2.2) in the remaining patients (p=.003); in the multivariate analysis: OR 0.51, 95% CI (0.2-0.9), p<.05.

CONCLUSIONS

PRB is a procedure that is not without risk, since minor complications occurred in 19.1% and major complications in 3.7% of cases. Pre-PRB Hb is an independent risk factor for the development of major complications.

摘要

背景

经皮肾活检(PRB)是肾脏病研究中的一项关键侵入性技术,且与相当高的发病率相关。回顾性研究表明,10% - 20%的病例出现轻微并发症,1.2% - 6.6%的病例出现严重并发症。然而,这方面尚未进行前瞻性研究。

目的

我们研究的目的是前瞻性评估与原发性肾脏PRB相关的并发症。

方法

2009年1月至2013年5月,我们前瞻性分析了肾内科医生在超声引导下对原发性肾脏进行的PRB。我们分析了临床和实验室变量。我们将轻微并发症定义为血红蛋白(Hb)下降超过1g/dL,严重并发症定义为需要输血或采用侵入性技术。

结果

在此期间共进行了241次PRB。患者平均年龄为49岁(±17),大多数(56%)为男性,58.1%患有高血压。51%的病例进行了2次穿刺。46例患者(19.1%)出现轻微并发症,9例患者(3.7%)出现严重并发症。在单因素分析中,严重并发症患者PRB前Hb为10.3g/dL(±1.3),其余患者为12.3g/dL(±2.2)(p = 0.003);在多因素分析中:比值比0.51,95%置信区间(0.2 - 0.9),p < 0.05。

结论

PRB是一种并非没有风险的操作,因为19.1%的病例出现轻微并发症,3.7%的病例出现严重并发症。PRB前Hb是发生严重并发症的独立危险因素。

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