关键词: 肾活检, 肾出血, 肾脏病理类型, 髓皮比, 弓状动脉, 肾小球硬化, 肾间质纤维化

Abstract: Objective To evaluate the effects of different pathological types and histological features on bleeding events after ultrasound-guided percutaneous native renal biopsies. Methods Research subjects were 1 026 admitted patients who underwent renal biopsy in the second affiliated Hospital of Xi'an Jiaotong University from January 2019 to December 2021. We compared bleeding ratio among different pathological type groups. We calculated the medullocortical ratio, number of arcuate artery, glomerulosclerosis and interstitial fibrosis on stained sections of renal biopsy tissues. Correlations were analyzed between bleeding area size and each histological features. Finally we compared each histological feature among different pathological type groups. Results There were 343 (33.4%) cases with bleeding which were detected by ultrasound, including 5 cases (0.49%) with major bleeding which received therapy. The four pathological types with high bleeding rate were as follows: renal damage of Sjogren's syndrome (100%), acute/subacute renal tubular injury (66.7%), sclerosing nephritis (50.0%), and membranous/ endocapillary proliferative nephritis (50.0%). The three pathological types with low bleeding rate were as follows: minimal change nephropathy (25.3%), membranous/atypical membranous nephropathy (26.3%) and diabetic nephropathy (27.9%). Both medullocortical ratio(P=0.032) and number of arcuate artery (P=0.037) positively correlated with bleeding area size, while glomerulosclerosis and interstitial fibrosis were not significantly correlated with bleeding area size. These histological features did not differ between different pathological type groups. There were statistical differences in some clinical data of the common pathological types. Conclusion The bleeding rates were significantly different among pathological types. The medullocortical ratio and number of arcuate artery on renal biopsy tissue can affect on bleeding events after ultrasound-guided percutaneous native renal biopsies.

Key words: renal biopsy, bleeding events, renal pathological pattern, medullocortical ratio, arcuate artery, glomerulosclerosis, interstitial fibrosis