泌尿器科領域における腎生検の経験

Abstract

One hundred and ninety cases of renal biopsy were performed in our clinic for past ten years. They consist of 92 cases of male and 98 ones of female. Needle biopsy was done in 76 cases and open was in remaining 114 ones. In 110 out of 114 cases of open renal biopsy, a small specimen was resected on the operation for upper urinary tract, and four cases were for only biopsy. Needle biopsy was requested in the patients with suspected glomerulonephritis, nephritic syndrome, pyelonephritis, idiopathic renal bleeding and others. In this technique, an adequate specimen of renal tissue was obtained in about 86.8% of the attempts. The histological examination revealed the noticeable abnormal findings of renal tissue (interstitial nephritis and contracted kidney) in 37.5% of the patients of nephroptosis with stubborn lumbago. And it will indicate that nephropexy may be required in the cases of nephroptosis without symptoms to prevent the renal damage resulting from recurrent urinary tract infection. In five of seventeen patients diagnosed as idiopathic renal bleeding, glomerulonephritis was histologically demonstrated and a careful attention should be taken in such cases. Four complications of needle renal biopsy were experienced and they were a large perirenal hematoma, an arteriovenous fistula, injuries to the liver and to the pancreas. But we had none in open series. Renal arteriovenous fistula secondary to percutaneous renal biopsy was briefly reviewed in literatures.