Still afraid of kidney puncture? Be careful to miss the opportunity to stop the drug

What is a kidney puncture?

Renal biopsy is a method used to extract the kidney tissue for laboratory analysis carried out, it is also known as renal biopsy renal biopsy (renal biopsy)
.

At present, the most commonly used is percutaneous kidney biopsy guided by B-ultrasound .
Under the guidance of B-ultrasound, it is accurately positioned at the lower pole of the kidney, the puncture needle is pierced into the skin, and the subcutaneous tissue is directly pierced into the kidney, and a small amount of kidney tissue is quickly removed for pathological analysis .
 

Is a small kidney puncture important?

Renal biopsy is the most effective method for obtaining kidney specimens and is the gold standard for the diagnosis of kidney disease [1]
.

Clinically, the classification of active renal tissue lesions can be diagnosed based on renal biopsy pathology, which is of great value in the diagnosis and treatment of lupus nephritis and the evaluation of its prognosis [2]

In July this year, the Asia Pacific Rheumatology Alliance (APLAR) formulated the first systemic lupus erythematosus (SLE) management consensus [3], which still emphasized the importance of kidney biopsy for lupus nephritis, due to clinical symptoms and proteinuria.

the severity of a certain school-related kidney, thrombotic microangiopathy vessels between disease, foot cell disease and renal tubular interstitial disease can only be found by histological examination, biopsy can also provide science and severity of chronic diseases become active and organized Information

If the terminology is difficult to understand, then Huzhujun will use an analogy: Your computer often crashes and black screens recently.

This is like proteinuria and hematuria after kidney injury, but you don’t know which one of your computer has the problem.

When should kidney puncture be done?

When butterfly friends have the following two situations, it is generally recommended to do a renal puncture examination
.

1.
Poor control of proteinuria after treatment

Long-term proteinuria will cause the progressive development of kidney disease.
If the proteinuria treatment of butterfly friends for more than 3 months, the large urine protein index still does not decrease significantly , a renal puncture can be considered to determine whether it is lupus nephritis and its pathological type
.

Huzhujun remembered a butterfly friend who had a positive urine protein and had been treated as a treatment for lupus nephritis, but the urine protein index did not improve.
After a few years, it was only after a kidney biopsy that he was diagnosed with IGA nephropathy and it has developed.
It's level V! Even missed the opportunity to stop the drug
.

Image source: Chat with Mijian and Dieyou

Therefore, don't hesitate all the time when you need a kidney puncture, or you will be like this butterfly friend.
After several years of treatment for lupus nephritis, the treatment for lupus nephritis will be wrong after all, and the disease will develop to the point where it is difficult to reverse!

2.
Acute progression of unknown cause

Most of the development of lupus nephritis is relatively slow, but there are also "urgent" times
.

If lupus nephritis develops active lesions and "emergency" occurs, such as rapid increase in urine protein and blood creatinine, but the cause cannot be diagnosed by other tests, renal puncture should be performed as soon as possible to confirm the diagnosis
.

Contraindications of renal puncture

Absolute contraindications:

1.
Laboratory examinations show that patients with obvious coagulation dysfunction or patients with obvious bleeding tendency;

2.
Mental illness or children unable to cooperate with the operator;

3.
Severe hypertension;

4.
Small kidney;

5.
Isolated kidney
.

    Relative contraindications:

1.
Patients with renal tumors or renal aneurysms;

2.
Active pyelonephritis, renal tuberculosis;

3 Heart failure, hypovolemia, pregnancy, severe anemia;

4.
Obesity;

5.
Chronic renal failure;

6.
The kidney is too high;

7.
Renal abscess, hydronephrosis or empyema;

8.
Those with polycystic kidney or large kidney cyst;

9.
Severe ascites or migrating kidney
.

Precautions before and after renal puncture

Before renal puncture:

1.
Perform routine inspections to find out blood, clotting time, platelet count, prothrombin time, and understand whether there is bleeding tendency; check blood creatinine, urea nitrogen, and understand kidney function
.

2.
Before the kidney puncture, the patient should practice bed urination , because the patient needs to be in bed within 24 hours after the operation
.

3.
Before the operation, the patient also needs to practice breath-holding .
Generally, 6-7 seconds of breath-holding is enough
.

This is because during a renal puncture, the patient needs to hold his breath when the needle is inserted, otherwise the kidneys will move up and down with the breath

 

4.
Before renal puncture, ensure smooth stool .
Two days before renal puncture , it is best to be vegetarian.
Do not eat beans, meat, or dairy foods, otherwise it is easy to produce gas and cause the B-ultrasound display to be unclear and unable to perform the puncture
.

 

5.
The night before renal puncture, keep enough sleep , eat less breakfast on the day of renal puncture, and empty the bladder before surgery
.

 After renal puncture:

1.
Generally, patients need to stay in bed for 24 hours after renal puncture to reduce physical activity , which can reduce bleeding
.

After the operation, drink plenty of water to promote urination, which helps to drain the blood and avoid the formation of blood clots

2.
After kidney puncture, blood pressure should be monitored.
Pay attention to the color of urine, whether there are blood clots , and follow the doctor's instructions to save urine for examination
.

If you feel unwell, tell the medical staff in time

 

3.
In case of gross hematuria, low back pain or obvious abdominal pain, stay in bed, immobilize, keep the stool unobstructed, avoid actions that increase abdominal pressure , and use hemostatic drugs if necessary
.

 

4.
After the kidney through a within months, not the waist strenuous activities such as running, lifting heavy objects, etc.
, in order to avoid bleeding
.

Avoid sex within one month after renal puncture

 

Several issues that butterfly friends care about

1.
Will puncture damage kidney function?

A normal person has about one hundred to two million glomeruli on one side of the kidney.
Two to three pieces of kidney tissue and dozens of glomeruli are taken from a renal puncture, which is only a fraction of the whole kidney
.

In addition, the technology of renal puncture is very mature.
As long as you cooperate with the doctor during the operation, kidney damage will not usually occur
.

2.
Does kidney puncture hurt?

Before renal biopsy, local anesthetics will be used.
Except for some acupuncture pain during local anesthesia, the patient has no pain during the whole process after anesthesia.
After the puncture, the patient just feels a little sore in the waist
.
But the perception of pain varies from person to person, and some people may feel a little uncomfortable
.

3.
How long does the puncture process take?

At present, the technology of renal puncture is very mature, and the puncture process generally does not take more than half an hour
.

4.
Is renal puncture expensive?

Many butterfly friends are concerned about the price of renal puncture.
Due to the different consumption levels in different regions, the costs of different regions and hospitals are also different.
The cost of renal puncture ranges from 3,000 to 10,000 yuan , and some of the costs can be reimbursed by medical insurance
.

5.
Can the puncture be done twice?

Yes
.
Renal puncture is used to determine the type of pathology, and it is generally not necessary to do it twice in a short period of time
.
However, it must also be combined with the specific condition.
In clinical practice, sometimes in order to know the treatment effect or the progress of the disease, it is necessary to repeat the pathological examination.
For example, the kidney damage of Dieyou is progressing rapidly, and the treatment effect is not ideal.
Check
.

Warm reminder: This article is based on disease science sharing and cannot replace hospital visits
.
Opinions are for reference only, please follow the doctor's advice for specific treatment methods
.

What is a kidney puncture?

What is a kidney puncture? What is a kidney puncture?

Renal biopsy is a method used to extract the kidney tissue for laboratory analysis carried out, it is also known as renal biopsy renal biopsy (renal biopsy)
.

Kidney biopsy

At present, the most commonly used is percutaneous kidney biopsy guided by B-ultrasound .
Under the guidance of B-ultrasound, it is accurately positioned at the lower pole of the kidney, the puncture needle is pierced into the skin, and the subcutaneous tissue is directly pierced into the kidney, and a small amount of kidney tissue is quickly removed for pathological analysis .
 

 Percutaneous kidney biopsy guided by B ultrasound B ultrasound guided percutaneous kidney biopsy

Is a small kidney puncture important?

Is a small kidney puncture important? Is a small kidney puncture important?

Renal biopsy is the most effective method for obtaining kidney specimens and is the gold standard for the diagnosis of kidney disease [1]
.
Clinically, the classification of active renal tissue lesions can be diagnosed based on renal biopsy pathology, which is of great value in the diagnosis and treatment of lupus nephritis and the evaluation of its prognosis [2]
.

It is the most effective method for obtaining kidney specimens and the gold standard diagnosis for the diagnosis of kidney disease

In July this year, the Asia Pacific Rheumatology Alliance (APLAR) formulated the first systemic lupus erythematosus (SLE) management consensus [3], which still emphasized the importance of kidney biopsy for lupus nephritis, due to clinical symptoms and proteinuria.
the severity of a certain school-related kidney, thrombotic microangiopathy vessels between disease, foot cell disease and renal tubular interstitial disease can only be found by histological examination, biopsy can also provide science and severity of chronic diseases become active and organized Information
.
If there are no contraindications, patients with active lupus nephritis should undergo renal biopsy before immunosuppressive therapy
.

Management consensus thrombotic vascular but for the presence contraindications, active lupus nephritis patients should be immune renal biopsy before treatment to suppress the immune

If the terminology is difficult to understand, then Huzhujun will use an analogy: Your computer often crashes and black screens recently.
This is like proteinuria and hematuria after kidney injury, but you don’t know which one of your computer has the problem.
, What kind of problem has occurred, at this time, you have to ask professional maintenance personnel to take out some parts of the computer for repair (just like kidney puncture to take out the damaged kidney tissue for inspection), just check out where the problem is.
Treated symptomatically
.

When should kidney puncture be done?

When should kidney puncture be done? When should kidney puncture be done?

When butterfly friends have the following two situations, it is generally recommended to do a renal puncture examination
.

1.
Poor control of proteinuria after treatment

Long-term proteinuria will cause the progressive development of kidney disease.
If the proteinuria treatment of butterfly friends for more than 3 months, the large urine protein index still does not decrease significantly , a renal puncture can be considered to determine whether it is lupus nephritis and its pathological type
.

After treatment for proteinuria for more than 3 months, the index of large urine protein still did not decrease significantly , and after treatment for proteinuria for more than 3 months, the index of large urine protein still did not decrease significantly.

Huzhujun remembered a butterfly friend who had a positive urine protein and had been treated as a treatment for lupus nephritis, but the urine protein index did not improve.
After a few years, it was only after a kidney biopsy that he was diagnosed with IGA nephropathy and it has developed.
It's level V! Even missed the opportunity to stop the drug
.

Missed the opportunity to stop the drug

Image source: Chat with Mijian and Dieyou

Image source: Chat with Mijian and Dieyou

Therefore, don't hesitate all the time when you need a kidney puncture, or you will be like this butterfly friend.
After several years of treatment for lupus nephritis, the treatment for lupus nephritis will be wrong after all, and the disease will develop to the point where it is difficult to reverse!

2.
Acute progression of unknown cause

Most of the development of lupus nephritis is relatively slow, but there are also "urgent" times
.

If lupus nephritis develops active lesions and "emergency" occurs, such as rapid increase in urine protein and blood creatinine, but the cause cannot be diagnosed by other tests, renal puncture should be performed as soon as possible to confirm the diagnosis
.

Active lesions in lupus nephritis

Contraindications of renal puncture

Contraindications of renal puncture Contraindications of renal puncture

Absolute contraindications:

Absolute contraindications:

1.
Laboratory examinations show that patients with obvious coagulation dysfunction or patients with obvious bleeding tendency;

2.
Mental illness or children unable to cooperate with the operator;

3.
Severe hypertension;

4.
Small kidney;

5.
Isolated kidney
.

    Relative contraindications:

    Relative contraindications:

1.
Patients with renal tumors or renal aneurysms;

2.
Active pyelonephritis, renal tuberculosis;

3 Heart failure, hypovolemia, pregnancy, severe anemia;

4.
Obesity;

5.
Chronic renal failure;

6.
The kidney is too high;

7.
Renal abscess, hydronephrosis or empyema;

8.
Those with polycystic kidney or large kidney cyst;

9.
Severe ascites or migrating kidney
.

Precautions before and after renal puncture

Precautions before and after renal puncture Precautions before and after renal puncture

Before renal puncture:

Before renal puncture:

1.
Perform routine inspections to find out blood, clotting time, platelet count, prothrombin time, and understand whether there is bleeding tendency; check blood creatinine, urea nitrogen, and understand kidney function
.

2.
Before the kidney puncture, the patient should practice bed urination , because the patient needs to be in bed within 24 hours after the operation
.

Practice bed urination

3.
Before the operation, the patient also needs to practice breath-holding .
Generally, 6-7 seconds of breath-holding is enough
.
This is because during a renal puncture, the patient needs to hold his breath when the needle is inserted, otherwise the kidneys will move up and down with the breath
.

Practice holding your breath

 

4.
Before renal puncture, ensure smooth stool .
Two days before renal puncture , it is best to be vegetarian.
Do not eat beans, meat, or dairy foods, otherwise it is easy to produce gas and cause the B-ultrasound display to be unclear and unable to perform the puncture
.

Ensure smooth stool

 

Keep enough sleep to empty the bladder before surgery

 After renal puncture:

 After renal puncture: After renal puncture:

1.
Generally, patients need to stay in bed for 24 hours after renal puncture to reduce physical activity , which can reduce bleeding
.
After the operation, drink plenty of water to promote urination, which helps to drain the blood and avoid the formation of blood clots
.

Stay in bed for 24 hours, reduce physical activity

2.
After kidney puncture, blood pressure should be monitored.
Pay attention to the color of urine, whether there are blood clots , and follow the doctor's instructions to save urine for examination
.
If you feel unwell, tell the medical staff in time
.

Monitor blood pressure, pay attention to the color of urine, whether there are blood clots

 

3.
In case of gross hematuria, low back pain or obvious abdominal pain, stay in bed, immobilize, keep the stool unobstructed, avoid actions that increase abdominal pressure , and use hemostatic drugs if necessary
.

Avoid actions that increase abdominal pressure

 

4.
After the kidney through a within months, not the waist strenuous activities such as running, lifting heavy objects, etc.
, in order to avoid bleeding
.
Avoid sex within one month after renal puncture
.

A within months within months, not strenuous activity waist

 

Several issues that butterfly friends care about

Several issues that butterfly friends care about Several issues that butterfly friends care about

1.
Will puncture damage kidney function?

A normal person has about one hundred to two million glomeruli on one side of the kidney.
Two to three pieces of kidney tissue and dozens of glomeruli are taken from a renal puncture, which is only a fraction of the whole kidney
.
In addition, the technology of renal puncture is very mature.
As long as you cooperate with the doctor during the operation, kidney damage will not usually occur
.

2.
Does kidney puncture hurt?

Before renal biopsy, local anesthetics will be used.
Except for some acupuncture pain during local anesthesia, the patient has no pain during the whole process after anesthesia.
After the puncture, the patient just feels a little sore in the waist
.
But the perception of pain varies from person to person, and some people may feel a little uncomfortable
.

3.
How long does the puncture process take?

At present, the technology of renal puncture is very mature, and the puncture process generally does not take more than half an hour
.

4.
Is renal puncture expensive?

Many butterfly friends are concerned about the price of renal puncture.
Due to the different consumption levels in different regions, the costs of different regions and hospitals are also different.
The cost of renal puncture ranges from 3,000 to 10,000 yuan , and some of the costs can be reimbursed by medical insurance
.

3000--10000 yuan

5.
Can the puncture be done twice?

Yes
.
Renal puncture is used to determine the type of pathology, and it is generally not necessary to do it twice in a short period of time
.
However, it must also be combined with the specific condition.
In clinical practice, sometimes in order to know the treatment effect or the progress of the disease, it is necessary to repeat the pathological examination.
For example, the kidney damage of Dieyou is progressing rapidly, and the treatment effect is not ideal.
Check
.

Warm reminder: Warm reminder: This article is based on disease science sharing and cannot replace hospital visits
.
Opinions are for reference only, please follow the doctor's advice for specific treatment methods
.
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