Post Date April, 15 2023
Can puncture treat nephrotic syndrome? Renal puncture, also known as nephropuncture, is the only method for pathological diagnosis of kidney disease. Under the guidance of B-ultrasound, the doctor inserts a specially designed needle tube under the left posterior twelfth rib through a skin or surgical incision, and cuts a small piece of kidney tissue for pathological examination. If it is a kidney transplant patient, the cutting site is the left or right side of the abdomen. Renal puncture is somewhat traumatic, but it has minimal damage to the kidneys. However, some patients with renal puncture may experience the following symptoms or complications, such as:
(1) Hematuria: The incidence of microscopic hematuria is almost 100%, often disappearing within 1-5 days after surgery and does not require treatment. When very few patients experience severe bleeding, blood transfusion or infusion should be performed to monitor blood pressure and hemoglobin. If blood pressure cannot be maintained after rescue, selective renal artery angiography should be considered to determine the location of the bleeding and decide to use arterial embolization or surgery.
(2) Infection: The incidence of infection is low, mainly due to lax aseptic measures, existing infection around the kidney or accompanied by pyelonephritis. If fever, severe back pain, or elevated white blood cells occur, antibiotic treatment is required.
(3) Perirenal hematoma: The incidence of perirenal hematoma is about 60-90%, generally small, asymptomatic, and often absorbed within 1-2 weeks. Large hematoma is rare and often caused by renal laceration or puncture into large and medium-sized blood vessels, especially arteries. It often occurs on the day of puncture, manifested as abdominal pain, low back pain, tenderness at the puncture site or slight swelling on the opposite side, abdominal tenderness and rebound pain on the puncture side, and in severe cases, a decrease in blood pressure and hematocrit. B-ultrasound or X-ray examination can further confirm this. Conservative treatment is generally adopted, and if bleeding persists, surgical treatment can be performed.
(4) Injury to other organs: It is often caused by improper puncture points or excessively deep needle insertion, and severe cases require surgical treatment.
(5) Arteriovenous fistula: The incidence rate is 15-19%, and most patients have no symptoms. Typical manifestations include severe hematuria and/or perirenal hematoma, refractory hypertension, progressive heart failure, and lumbar abdominal vascular murmur. Diagnosis requires renal angiography, and most cases heal spontaneously within 3 to 30 months. In severe cases, surgery should be performed promptly.
(6) Low back pain: The incidence rate is about 17-60%, and it disappears within more than a week. (7) Death: The incidence rate is 0-0.1%, and death occurs due to severe bleeding, infection, organ damage, or other systemic complications.
Due to the different complications of nephrotic syndrome, the treatment methods adopted are also different, and not everyone is suitable for puncture treatment. Patient friends should first understand their own situation before deciding on treatment methods. The most scientific approach is to treat according to medical affiliation.
