When should renal puncture be performed?

Renal puncture is also a relatively common means of examination. It is also called renal biopsy. The full name is renal puncture biopsy. We know that there are many types of kidney disease, and its causes and pathogenesis are also relatively complex. Therefore, when similar symptoms appear, renal puncture examination may be required to clarify the specific cause. When performing a renal puncture examination, you must understand some precautions. Let us take a look at this aspect.

When should renal puncture be performed?

⑴ Various types of glomerulonephritis, glomerular nephropathy, nephrotic syndrome, kidney diseases caused by systemic diseases such as systemic lupus erythematosus, amyloid degeneration, diabetes, Henoch-Schonlein purpura, uric acid nephropathy, nodular periarteritis, etc. ⑵ Persistent asymptomatic proteinuria and hematuria of unknown cause, and hypertension of unknown cause. ⑶Acute tubular and interstitial lesions. Atypical chronic pyelonephritis, especially when it is difficult to differentiate from chronic nephritis, requires a renal biopsy to confirm the diagnosis. ⑷ In case of unexplained acute renal failure which is difficult to diagnose and treat, or in case of chronic kidney disease of unknown cause and sudden worsening of the condition, a renal biopsy can help to clarify the diagnosis and guide the treatment.

Contraindications

Renal puncture is a traumatic examination. When selecting cases for puncture, one must not only understand the indications but also carefully exclude the contraindications. ⑴ Absolute contraindications: ① Obvious bleeding tendency, ② Severe hypertension, ③ Mental illness or uncooperative patients, ④ Solitary kidney, ⑤ Small kidney. ⑵Relative contraindications: ①Active pyelonephritis, renal tuberculosis, hydronephrosis or pyonephrosis, renal abscess or perinephric abscess. ② Kidney tumor or renal artery aneurysm. ③Polycystic kidney disease or large kidney cysts. ④ The kidney is too high (even with a deep breath, the lower end of the kidney does not reach below the twelfth rib) or it is a wandering kidney. ⑤Chronic renal failure. ⑥Excessive obesity. ⑦ Severe ascites. ⑧People with heart failure, severe anemia, hypovolemia, pregnancy or the elderly.