Frotscher U
Fortschr Med. 1978 Oct 26;96(40):2045-8.
The evaluation of the results of nearly 800 percutaneous renal biopsies, including biopsies in which insufficient renal tissue was obtained or histologic changes were non-specific, indicated that in 85% of the cases a positive diagnosis could be made. The liberal extension of the indication to percutaneous renal biopsy to include oligosymptomatic renal diseases, the nephrotic syndrome and acute renal failure often resulted in therapeutic and prognostic consequences. Renal biopsy does not facilitate the diagnosis of pyelonephritis. Uremia, severe atherosclerosis, small kidneys, advanced age and lack of cooperation are not contraindications to percutaneous renal biopsy nor do they increase its risk. Severe complications are extremely rare and are always secondary to retroperitoneal hemorrhage. Close observation and prompt treatment can always preclude a fatal outcome. Long-term complications are not to be expected. If the technique of percutaneous renal biopsy and its histologic evaluation are efficiently performed, further extension of the indications to biopsy could be medically sanctioned.
对近800例经皮肾活检结果的评估,包括肾组织获取不足或组织学改变不具特异性的活检,表明85%的病例可做出阳性诊断。经皮肾活检适应证的放宽,将无症状性肾病、肾病综合征和急性肾衰竭纳入其中,常常导致治疗和预后方面的后果。肾活检无助于肾盂肾炎的诊断。尿毒症、严重动脉粥样硬化、小肾脏、高龄及不合作并非经皮肾活检的禁忌证,也不会增加其风险。严重并发症极为罕见,且总是继发于腹膜后出血。密切观察和及时治疗总能避免致命后果。预计不会出现长期并发症。如果能有效地进行经皮肾活检技术及其组织学评估,活检适应证的进一步扩展在医学上是可行的。