Mustonen J, Pasternack A, Helin H, Pystynen S, Tuominen T
Am J Nephrol. 1984;4(1):27-31. doi: 10.1159/000166768.
Renal biopsies were performed on 91 out of 99 patients with acute intrinsic renal failure. In all these 91 cases a clinical diagnosis was suggested by an experienced nephrologist unaware of the renal biopsy findings. Most diagnoses agreed with the histopathological findings, but there were important exceptions. On clinical grounds, acute tubulointerstitial renal disease was diagnosed correctly in 77% and acute glomerulonephritis in 56%. In 15% of the patients the clinical data did not permit any certain diagnostic suggestion. In about 20% the biopsy finding definitely influenced the choice of medical treatment. In those 15 patients who needed dialysis treatment, the biopsy findings helped in determining whether this need was temporary or permanent. Our results show that renal biopsy is valuable in settling the diagnosis, in determining the prognosis, and in planning the treatment of acute intrinsic renal failure.
99例急性肾实质性肾衰竭患者中,91例接受了肾活检。所有这91例患者均由一位不了解肾活检结果的经验丰富的肾脏病学家作出临床诊断。多数诊断与组织病理学结果相符,但也有重要的例外情况。基于临床判断,急性肾小管间质性肾病的正确诊断率为77%,急性肾小球肾炎为56%。15%的患者临床资料无法做出明确的诊断提示。约20%的患者活检结果明确影响了治疗方案的选择。在需要透析治疗的15例患者中,活检结果有助于确定这种需求是暂时的还是永久性的。我们的结果表明,肾活检对于明确急性肾实质性肾衰竭的诊断、判断预后及制定治疗方案具有重要价值。