PRACTICE OF CONDUCTING AND DIAGNOSING SIGNIFICANCE OF PUNCTURE KIDNEY BIOPSY IN THE REGIONAL HOSPITAL

Modern diagnosing of kidney diseases is based on a complex of clinical, laboratory, and instrumental studies, among which kidney biopsy occupies an important place. The study aims to assess the diagnostic value of kidney biopsy in patients with nephrological pathology. The study included 70 patients (n = 70) who underwent percutaneous puncture kidney biopsy from 2019 to 2022 for the following causes: nephrotic syndrome (42 %), chronic nephritic syndrome (35 %), and acute kidney injury of unclear etiology (23 %). The morphological examination revealed that two-thirds of all patients with kidney diseases (60 %) (p = 0,05) had glomerulopathy. Among glomerular diseases, IgA-nephropathy prevails (26 %) (p < 0,05), as well as membranous nephropathy (14 %). Amyloidosis (AA/Al) is registered in every seventh patient (14 %), while diabetic nephropathy – in every tenth (10 %). Complications of kidney biopsy develop in a quarter of cases (26 %). Anti-neutrophil cytoplasmic antibody-associated vasculitis, thrombotic microangiopathies and tubulointerstitial nephritis manifest more often in the form of acute kidney injury, IgA-nephropathy manifests itself in the onset of the disease with nephritic syndrome, while diabetic nephropathy, membranous nephropathy, focal segmental glomerulosclerosis, amyloidosis start with nephrotic syndrome in most cases. Kidney biopsy often has a significant impact on patient management tactics: according to the results of the morphological study, active pathogenetic therapy was initiated or corrected, and the vector of diagnostic search was also changed in 83 % of patients (p = 0,005). The data obtained confirm the need for the widespread introduction of kidney biopsy in order to optimize the quality of medical care provided to patients with a nephrological profile.

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