I have a friend who has suffered from chronic glomerulonephritis for two
years. His latest urine test shows: occult blood +3, urine protein +2. Doctors
suggest him do renal biopsy, but he worries that renal biopsy may also bring
trauma to kidney, which may affect his future life. For this reason, he asked me
whether renal biopsy is necessary for him.
Actually, whether patients with chronic nephritis need renal biopsy, is based
on their illness condition. Renal biopsy is a kind of pathological test, but not
a treatment. It is used to make sure which kind of kidney disease patients have.
Since kidney diseases are various and their pathogenesises are complicated,
sometimes clinical symptoms can not reflect the real histological change in
kidneys). Therefore, renal biopsy will be needed to make more exact
diagnosis.
At present, the result of renal pathological test has been the gold index to
diagnose kidney disease. Normally, the clinical significances of renal biopsy
can be listed as follows:
(1)Clearing diagnosis: More than one third clinical diagnosis can be revised
by renal biopsy.
(2)Guiding treat: more than one third clinical treatments will be corrected
by renal biopsy.
(3)Estimating prognosis: the result of renal biopsy is helpful to estimate
patients’ prognosis.
In addition, renal biopsy is needed again for pathological progress, such as
crescentic glomerulonephritis, lupus nephritis and IgA kidney diseases.
Patients with Chronic Glomerulonephritis take renal biopsy to clear
pathological diagnosis, which is helpful to find suitable treatments.
Generallyl, pathological diagnosis of renal biopsy are as follows:
MPGSN(includes IgA nephropathy), Membranoproliferative GN, membranous
nephropathy(MN), Focal segmental sclerosing glomerulonephritsi. At the same
time, it also includes various degrees pathological damage of glomeruli and
renal tubules.
In order to have exact diagnosis to guide treatment and estimate prognosis,
if there is no contraindication, all kinds of primary or secondary as well as
genetic kidney disease patients can be taken renal biopsy in order to make exact
diagnosis as well as guide treatment and estimate prognosis.
Secondary or genetic kidney disease nephropathy: Renal biopsy is still needed
if the renal pathological change is important to guide the treatment and
estimate prognosis, even though the disease is secondary or genetic which has
already been diagnosed clinically. Since renal biopsy is a traumatic test,
patients are not allowed to take renal biopsy if they have the following
conditions:
Absolute contraindication: obvious bleeding tendency, severe high blood
pressure (High Blood Pressure and Kidney Disease), mental diseases, solitary kidney, small kidney.
Relative contraindication: active pvelonephritis, nephrotuberculosis,
hydronephrosis or pyonephrosis, renal abscess or around renal abscess, renal
tumors or renal aneurysms, polycystic kidney or large kidney cysts, the place of
the kidneys are too high (the lower pole of the kidney can’t reach the twelfth
rib when in deep breath) or nephrospasia, chronic renal failure, obesity, severe
ascites, cardiac failure, serious anemia, low blood volume and pregnancy or old
people.
Patients with chronic glomerulonephritis should choose renal biopsy
cautiously, to sure they care suitable the condition.
Renal biopsy has side effects and there will be trauma after the test.
Sometimes, it also aggravates hematuria.
Though it is helpful to clear the pathology of chronic nephritis and is
helpful for clinical study, its guiding significance for patients to seek for
treatment is little. Since there are so many contraindications of renal biopsy
test, experts suggest patients with chronic glomerulonephritis take renal ECT
test, which can respond the kidney damage and have vital significance to
diagnose and treat the disease.