Significance Of Renal Biopsy in Renal Needle Biopsy

Understanding the changes of renal histomorphology provides an important basis for clinicians to judge the disease, treat the disease and estimate the prognosis. It can be said that the development of renal pathological examination is a leap in the development of nephrology. At present, the results of renal pathological examination have become the golden indicator for the diagnosis of renal diseases. In summary, the clinical significance of renal puncture examination mainly includes the following points:

(1) Clear diagnosis: Renal biopsy can correct the clinical diagnosis in more than one third of patients.

(2) Guiding treatment: The clinical treatment of nearly one third of patients can be modified by renal biopsy.

⑶ Estimate prognosis: Renal biopsy can be used to more accurately assess the prognosis of patients with kidney disease.

In addition, repeat renal pathology is sometimes necessary to understand the effect of treatment or to understand the progression of pathology (e.g., crescentic nephritis, lupus nephritis, and IgA nephropathy).

In order to confirm the diagnosis, guide the treatment or judge the prognosis, but without puncture contraindications, various primary, secondary and hereditary renal parenchymal diseases (especially diffuse lesions) can be renal puncture.

⑴ Primary kidney disease: ① Acute nephritis syndrome, rapid deterioration of renal function, suspected rapid progressive nephritis, should be punctured as soon as possible; According to the acute nephritis treatment for 2 ~ 3 months the condition does not improve should do renal perforation. ② Primary nephrotic syndrome, first treatment, hormone treatment for 8 weeks when the failure of renal puncture; Or puncture first, according to the pathological type of different treatment. ③ When the clinical diagnosis of asymptomatic hematuria and deformed red blood cell hematuria is unclear, when the diagnosis of asymptomatic proteinuria is not clear, albuminuria persists >1g/d, renal puncture examination should be done.

(2) Secondary or hereditary kidney disease: when the clinical diagnosis is not suspected, the clinical diagnosis has been confirmed, but the renal pathological data is of great significance to guide the treatment or judge the prognosis, renal puncture should be done.

⑶ Acute renal failure: Puncture should be performed promptly when clinical and laboratory tests cannot determine the cause (including acute deterioration of renal function in patients with chronic kidney disease).

(4) Kidney transplantation: ① when the cause of renal dysfunction is unclear, ② severe rejection decides whether to remove the transplanted kidney; ③ Suspected recurrence of the original kidney disease in the transplanted kidney.

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