肾活检

定义

A kidney biopsy is the removal of a small piece of kidney tissue for examination.

选择的名字

肾活检; Biopsy - kidney

如何执行测试

A kidney biopsy is done in the hospital. The two most common ways to do a kidney biopsy are percutaneous and open. 如下所述.

经皮活检

Percutaneous means through the skin. Most kidney biopsies are done this way. The procedure is usually done in the following way:

• You may receive medicine to make you drowsy.
• 你趴着. If you have a transplanted kidney, you lie on your back.
• The provider marks the spot on the skin where the biopsy needle is inserted.
• 皮肤清洁.
• Numbing medicine (anesthetic) is injected under the skin near the kidney area.
• The provider makes a tiny cut in the skin. 超声波 images are used to find the proper location. Sometimes another imaging method, such as CT，是常用的.
• The provider inserts a biopsy needle through the skin to the surface of the kidney. You are asked to take and hold a deep breath as the needle goes into the kidney.
• If the provider is not using ultrasound guidance, you may be asked to take several deep breaths. This allows the doctor to know the needle is in place.
• The needle may be inserted more than once if more than one tissue sample is needed.
• 针头被取出. Pressure is applied to the biopsy site to stop any bleeding.
• After the procedure, a bandage is applied to the biopsy site.

开放的活组织检查

In some cases, your doctor may recommend a surgical biopsy. This method is used when a larger piece of tissue is needed.

• You receive medicine (anesthesia) that allows you to sleep and be pain-free.
• The surgeon makes a small surgical cut (incision).
• The surgeon locates the part of the kidney from which the biopsy tissue needs to be taken. 组织被移除.
• The incision is closed with stitches (sutures).

After percutaneous or open biopsy, you will likely stay in the hospital for at least 12 hours. You will receive pain medicines and fluids by mouth or through a vein (IV). Your urine will be checked for heavy bleeding. A small amount of bleeding is normal after a biopsy.

Follow instructions about caring for yourself after the biopsy. This may include not lifting anything heavier than 10 pounds (4.5 kilograms) for 2 weeks after the biopsy.

如何准备考试

告诉你的医疗保健提供者:

• 关于你正在服用的药物, including vitamins and supplements, 草药, 非处方药
• 如果你有任何过敏
• If you have bleeding problems or if you take blood-thinning medicines such as warfarin (Coumadin), 氯吡格雷, 双嘧达莫(Persantine), fondaparinux (Arixtra), apixaban (Eliquis), dabigatran (Pradaxa), 或阿司匹林
• If you are or think you might be pregnant

考试的感觉如何

Numbing medicine is used, so the pain during the procedure is often slight. The numbing medicine may burn or sting when first injected.

After the procedure, the area may feel tender or sore for a few days.

You may see bright, red blood in the urine during the first 24 hours after the test. If the bleeding lasts longer, tell your provider.

为什么要进行测试

Your doctor may order a kidney biopsy if you have:

• An unexplained drop in kidney function
• 尿中带血 这不会消失
• 尿液中的蛋白质 在尿检时发现的
• A transplanted kidney, which needs to be monitored using a biopsy

正常的结果

A normal result is when the kidney tissue shows normal structure.

异常结果意味着什么

An abnormal result means there are changes in the kidney tissue. 这可能是由于:

• 感染
• Poor blood flow through the kidney
• Connective tissue diseases such as 系统性红斑狼疮
• Other diseases that may be affecting the kidney, such as diabetes
• 肾脏 移植排斥反应如果你做了移植手术

风险

风险包括:

• Bleeding from the kidney (in rare cases, may require a blood transfusion)
• Bleeding into the muscle, which might cause soreness
• 感染(小风险)

参考文献

Salama AD, Cook HT. 肾活检. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Karl S, Philip AM, Taal MW, eds. 布伦纳和雷克特的肾. 11日艾德. Philadelphia, PA: Elsevier; 2020:chap 26.

Topham PS, Chen Y. 肾活检. In: Feehally J, Floege J, Tonelli M, Johnson RJ, eds. Comprehensive Clinical Nephrology. 6日艾德. Philadelphia, PA: Elsevier; 2019:chap 6.