Torigoe Kenta, Sakamoto Ryosuke, Abe Shinichi, Muta Kumiko, Mukae Hiroshi, Nishino Tomoya
Department of Nephrology, Nagasaki University Hospital, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, Japan.
Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City 852-8501, Nagasaki, Japan.
J Clin Med. 2023 Jun 6;12(12):3877. doi: 10.3390/jcm12123877.
Percutaneous kidney biopsy is essential for diagnosing various kidney diseases. However, insufficient glomerular yield leads to misdiagnosis, a critical problem. We retrospectively investigated the risk of insufficient glomerular yield in percutaneous kidney biopsies. We included 236 patients who underwent percutaneous kidney biopsies between April 2017 and September 2020. We retrospectively analyzed the relationship between glomerular yield and patient characteristics. After the biopsy, 31 patients produced insufficient glomerular yields (cases with yielded glomeruli <10). Glomerular yield correlated negatively with hypertension (β = -0.13, = 0.04), and positively with glomerular density (β = 0.59, < 0.0001) and the volume of the biopsy core (number of punctures, number of biopsy cores, total length of biopsy core, length of core collected by one puncture, and cortical length). Patients yielding <10 glomeruli had lower glomerular densities (14.4 ± 1.6 vs. 22.9 ± 0.6/cm; < 0.0001). These results suggest that glomerular density is crucial to glomerular yield. Furthermore, glomerular density was negatively correlated with hypertension, diabetes, and age. Hypertension was independently associated with low glomerular density (β = -0.16, = 0.02). Thus, the glomerular yield was associated with glomerular density and biopsy core length, and hypertension might be related to glomerular yield via low glomerular density.
经皮肾活检对于诊断各种肾脏疾病至关重要。然而,肾小球获取量不足会导致误诊,这是一个关键问题。我们回顾性研究了经皮肾活检中肾小球获取量不足的风险。我们纳入了2017年4月至2020年9月期间接受经皮肾活检的236例患者。我们回顾性分析了肾小球获取量与患者特征之间的关系。活检后,31例患者的肾小球获取量不足(获取的肾小球数<10个)。肾小球获取量与高血压呈负相关(β = -0.13,P = 0.04),与肾小球密度呈正相关(β = 0.59,P < 0.0001)以及与活检组织芯的体积相关(穿刺次数、活检组织芯数量、活检组织芯总长度、一次穿刺获取的组织芯长度以及皮质长度)。获取肾小球数<10个的患者肾小球密度较低(14.4±1.6 vs. 22.9±0.6/立方厘米;P < 0.0001)。这些结果表明肾小球密度对肾小球获取量至关重要。此外,肾小球密度与高血压、糖尿病和年龄呈负相关。高血压与低肾小球密度独立相关(β = -0.16,P = 0.02)。因此,肾小球获取量与肾小球密度和活检组织芯长度相关,高血压可能通过低肾小球密度与肾小球获取量相关。