Can the diagnosis of kidney disease be confirmed without a renal puncture needle test?

Is this kidney puncture done or not? We first need to know what the kidney puncture is for? Many people can answer: Determine the type of pathology and see what kidney disease is. So, what is going on with renal puncture? Many people don't know this well, here is a popular science knowledge about kidney puncture:

The so-called renal puncture is to take out a part of the patient’s kidney tissue with an instrument (note: the kidney has been damaged, does taking a piece of tissue on the kidney aggravate the kidney damage?) and send it to the pathology department. The pathologist first objectively describes the light microscope, immunohistochemistry, and electron microscopy of the kidney specimen, and then the nephrologist combines the results of the pathology report and the patient's clinical situation to give a diagnosis.

1. Due to the wide variety of kidney diseases, the etiology and pathogenesis are complex, the clinical manifestations of many kidney diseases are not completely consistent with the histological changes of the kidneys. For example, the clinical manifestation is nephrotic syndrome, and the pathology can present various changes such as minimal lesions, mild lesions, mild mesangial hyperplasia, membranous nephropathy, mesangial proliferative nephritis, focal segmental sclerosis, etc. The treatment plan and the condition of the disease The development results also vary greatly.

2. The histopathological changes in different developmental stages of kidney disease are also inconsistent. For example, it is also IgA nephropathy, which can be pathologically manifested in almost all stages of development from nearly normal kidney tissue to most glomerular sclerosis. Therefore, understanding the changes of kidney tissue morphology provides an important basis for clinicians to judge the condition, treat the disease and estimate the prognosis.

3. We have learned that our kidneys are composed of more than 2 million nephrons. When the kidneys are sick, these nephrons will be injured in different degrees. It is impossible for us to take out these nephrons for examination one by one, only Select a few representatives to come out for dialogue, understand their injuries, in order to take corresponding measures, just like the election of the National People’s Congress, it is impossible for 1.3 billion people to go to the meeting. Renal puncture is to select 10 to 20 kidneys out of 2 million nephrons. Unit, look at the degree of damage to these nephrons, and can the penetrating nephrons really represent the full extent of damage to our kidneys?

4. Complications that may occur are ⑴hematuria: The incidence of hematuria under microscope is almost 100%, and it usually disappears within 1 to 5 days after surgery, without treatment. After the renal puncture needle penetrates the renal calyx or renal pelvis, gross hematuria may occur, which usually disappears in 1-3 days. Sometimes gross hematuria with blood clots will occur, and very few patients will have severe bleeding.

⑵Perrenal hematoma: The incidence of perrenal hematoma is about 60-90%. It is generally small and has no clinical symptoms. It is mostly absorbed within 1-2 weeks. Larger hematomas are rare and are mostly caused by kidney tears or penetration into large and medium blood vessels, especially arteries. They occur on the day of puncture. In severe cases, blood pressure and hematocrit are decreased. If the bleeding does not stop, surgery can be performed.

⑶ Lumbago: The incidence is about 17-60%, and it disappears in more than a week, but most patients will exist for life, especially on cloudy and rainy days.

⑷ Arteriovenous fistula: The incidence is 15-19%, and most patients have no symptoms. Typical manifestations are severe hematuria and/or perirenal hematoma, intractable hypertension, progressive heart failure, and lumbar and abdominal vascular murmurs. In severe cases, prompt surgery.

⑸Injury to other organs: Most of the organs are damaged by improper puncture points or deep needles. In severe cases, surgical treatment is required.

⑹Infection: The incidence of infection is low, mostly due to inadequate aseptic measures, pre-renal infection or pyelonephritis, such as fever, severe low back pain, and leukocyte increase require antibiotic treatment.

⑺Death: The incidence rate is 0-0.1%. Death is due to severe bleeding, infection, organ damage or other systemic complications.

"At the beginning, it is good to have a kidney puncture, and the diagnosis can be confirmed! But the complications after this look are a bit scary, so now is there a test that can diagnose kidney disease without a kidney puncture? Is it not diagnosed? It won't be cured!

Don’t worry, in fact, kidney puncture is a histological examination, and it is more one-sided and relatively lagging behind, because now there are many examinations that can examine the cells of the kidney in detail. The tissue is composed of cells, and which ones Symptoms are corresponding to which type of cell, so look at the cell, and look at the cause of the cell damage!

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