Biopsia renal percutanea experiencia en el Hospital Materno Infantíl - Caja Nacional de Salud
Date
Journal Title
Journal ISSN
Volume Title
Publisher
Rev. bol. ped.
Abstract
Objetivo: mostrar la experiencia y seguridad de la biopsia renal percutanea en el diagnóstico de las enfermedades glomerulares del Hospital Materno Infantil de la Caja Nacional de Salud. Material y Método: retrospectivo, descriptivo (serie de casos) longitudinal, sobre nueve biopsias renales percutaneas de riñón nativo en el periodo agosto 2003 y febrero 2004 en pacientes con síndrome nefrotico primario corticoresistente, con insuficiencia renal, mayores de 10 años, con hematuria y/o síndrome nefrótico secundario; hematuria con proteinuria; síndrome nefrítico con insuficiencia renal o asociado a síndrome nefrotico. Cada paciente tuvo examen clínico, laboratorial y ecografico antes y después de la biopsia. Resultados: predomino el sexo masculino (77.7%), edad promedio 12.3 años y mediana 13 años. Los patrones histológicos fueron: glomerulonefritis proliferativa mesangial (3) glomerulonefritis lupica (2), glomeruloesclosis focal y segmentaría (1), glomerulonefritis endocapilar difusa con necrosis tubular aguda (1), glomerulonefritis membranosa (1), glomerulonefritis membranoproliferativa (1). Tres pacientes con insuficiencia renal correspondieron a glomerulonefritis proliferativa mesangial grado III, glomerulonefritis proliferativa endocapilar con necrosis tubular aguda y glomerulonefritis lupica con semilunas. Dos pacientes presentaron complicaciones menores y ninguno complicación mayor. Cinco pacientes recibieron sedación analgesia. Conclusión: La biopsia renal es un medio de diagnóstico seguro cuya indicación estará basada en la sospecha clínica a la luz de las pruebas complementarias realizadas.
Objective: to show the experience and security of percutaneous renal biopsy in the diagnosis of glomerulophaties of the Hospital Materno Infantil of the Caja Nacional de Salud. Material and Method: retrospective, descriptive (series of cases) longitudinal, about nine percutaneous renal biopsies of native kidney in the period August 2003 and February 2004 in patient with primary nephrotic syndrome steroid resistant, with renal failure, older than 10 years, with haematuria and/or secondary nephrotic syndrome; haematuria with proteinuria; nephritic syndrome with renal failure or associated to nephrotic syndrome. Each patient had clinical exam, blood chemistry and renal ultrasonography before and after the biopsy. Results: masculine sex (77.7%), age average 12.3 years and medium 13 years. The histopathology was: proliferative mesangial glomerulonephritis (3) lupus glomerulonephritis (2), focal and segmental glomerulosclerosis (1), and proliferative diffuse endocapillary glomerulonephritis with acute tubular necrosis (1), membranous glomerulonephritis (1) and membranoproliferative glomerulonephritis (1). Three patients with renal failure corresponded to proliferative mesangial glomerulonephritis grade III, proliferative endocapillary diffuse glomerulonephritis with acute tubular necrosis and lupus glomerulonephritis with crescents. Two patients presented minor complications and none serious complication. Five patients received sedation - analgesia. Conclusion: The renal biopsy is a secure procedure for diagnosis whose indication will be based on the clinical suspicion by the light of the complementary tests.
Objective: to show the experience and security of percutaneous renal biopsy in the diagnosis of glomerulophaties of the Hospital Materno Infantil of the Caja Nacional de Salud. Material and Method: retrospective, descriptive (series of cases) longitudinal, about nine percutaneous renal biopsies of native kidney in the period August 2003 and February 2004 in patient with primary nephrotic syndrome steroid resistant, with renal failure, older than 10 years, with haematuria and/or secondary nephrotic syndrome; haematuria with proteinuria; nephritic syndrome with renal failure or associated to nephrotic syndrome. Each patient had clinical exam, blood chemistry and renal ultrasonography before and after the biopsy. Results: masculine sex (77.7%), age average 12.3 years and medium 13 years. The histopathology was: proliferative mesangial glomerulonephritis (3) lupus glomerulonephritis (2), focal and segmental glomerulosclerosis (1), and proliferative diffuse endocapillary glomerulonephritis with acute tubular necrosis (1), membranous glomerulonephritis (1) and membranoproliferative glomerulonephritis (1). Three patients with renal failure corresponded to proliferative mesangial glomerulonephritis grade III, proliferative endocapillary diffuse glomerulonephritis with acute tubular necrosis and lupus glomerulonephritis with crescents. Two patients presented minor complications and none serious complication. Five patients received sedation - analgesia. Conclusion: The renal biopsy is a secure procedure for diagnosis whose indication will be based on the clinical suspicion by the light of the complementary tests.
Description
Vol. 43, No. 2