Torigoe Kenta, Muta Kumiko, Tsuji Kiyokazu, Yamashita Ayuko, Abe Shinichi, Ota Yuki, Mukae Hiroshi, Nishino Tomoya
Department of Nephrology, Nagasaki University Hospital, Nagasaki 852-8501, Japan.
Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki 852-8501, Japan.
Healthcare (Basel). 2021 Apr 16;9(4):474. doi: 10.3390/healthcare9040474.
Percutaneous renal biopsy is an essential tool for diagnosing various renal diseases; however, little is known about whether renal biopsy performed by physicians with short nephrology experience is safe in Japan. This study included 238 patients who underwent percutaneous renal biopsy between April 2017 and September 2020. We retrospectively analyzed the frequency of post-renal biopsy complications (hemoglobin decrease of ≥10%, hypotension, blood transfusion, renal artery embolization, nephrectomy and death) and compared their incidence among physicians with varied experience in nephrology. After renal biopsy, a hemoglobin decrease of ≥10%, hypotension and transfusion occurred in 13.1%, 3.8% and 0.8% of patients, respectively. There were no cases of post-biopsy renal artery embolism, nephrectomy, or death. The composite complication rate was 16.0%. The incidence of post-biopsy complications was similar between physicians with ≥3 years and <3 years of clinical nephrology experience (12.5% vs. 16.8%, = 0.64). Furthermore, the post-biopsy composite complication rates were similar between physicians with ≥6 months and <6 months of clinical nephrology experience (16.3% vs. 15.6%, > 0.99). Under attending nephrologist supervision, a physician with short clinical nephrology experience can safely perform renal biopsy.
经皮肾活检是诊断各种肾脏疾病的重要手段；然而，在日本，对于肾病经验不足的医生进行肾活检是否安全，人们知之甚少。本研究纳入了2017年4月至2020年9月期间接受经皮肾活检的238例患者。我们回顾性分析了肾活检后并发症（血红蛋白下降≥10%、低血压、输血、肾动脉栓塞、肾切除术和死亡）的发生频率，并比较了不同肾病经验医生之间的发生率。肾活检后，分别有13.1%、3.8%和0.8%的患者出现血红蛋白下降≥10%、低血压和输血情况。没有活检后肾动脉栓塞、肾切除术或死亡的病例。复合并发症发生率为16.0%。临床肾病经验≥3年和<3年的医生之间，活检后并发症的发生率相似（12.5%对16.8%，P = 0.64）。此外，临床肾病经验≥6个月和<6个月的医生之间，活检后复合并发症发生率相似（16.3%对15.6%，P>0.99）。在肾科主治医生的监督下，临床肾病经验不足的医生可以安全地进行肾活检。
