Objective To explore the clinical value of ultrasound-guided percutaneous renal biopsy in the diagnosis of diabetic nephropathy and analyze its safety.Methods A total of 130 diabetic patients who underwent ultrasound-guided percutaneous renal biopsy in our hospital were selected to observe the puncture and sampling conditions,and the incidence and classification of nephropathy were analyzed.Patients were divided into the complication group and the non-complication group according to whether there were complications at 72 h after operation,and the differences in sex,age,puncture times,preoperative serum creatinine level and renal parenchyma thickness between the two groups were compared.Logistic regression analysis was used to analyze the independent influencing factors of postoperative complications.Results All 130 diabetic patients were successfully punctured,each patient was punctured 2～4 times,with an average of(2.86±0.33)times.Sufficient glomeruli were obtained in all patients,2～41 glomeruli in each patient,with an average of 30.71±4.75,and the success rate was 100%.Nephropathy was detected in 92 patients,with a prevalence rate of 70.77%(92/130),including 61 cases(46.92%)of diabetic nephropathy and 31 cases(23.85%)of non-diabetic nephropathy.Among the non-diabetic nephropathy,there were 17 cases of IgA nephropathy,8 cases of membranous nephropathy,2 cases of mesangial glomerulonephritis,2 cases of amyloidosis and 2 cases of micro-polyarteritis.There were 41 cases in the complications group after operation,mainly including 28 cases of perirenal hematoma(23 cases of small hematoma,5 cases of large hematoma)and 13 cases of gross hematuria,with a total incidence of 31.54%(41/130).The proportion of age≥60 years old,renal parenchymal thickness<1.5 cm,number of puncture≥3 times and preoperative serum creatinine level>70 μmol/L in the complication group was higher than those in the non-complication group,the differences were statistically significant(all P<0.001).The difference in gender between the two groups was not statistically significant.Logistic regression analysis showed that age≥60 years,renal parenchymal thickness<1.5 cm,number of punctures≥3 times,and preoperative blood creatinine level>70 μmol/L were all independent risk factors for postoperative complications(OR=3.310,4.245,4.738,3.653,all P<0.001).Conclusion Ultrasound-guided percutaneous renal biopsy is an important method for diagnosing nephropathy in diabetic patients with a high success rate of sampling.The common postoperative complications include gross hematuria and perirenal hematoma.Age≥60 years old,renal parenchyma thickness<1.5 cm,number of puncture≥3 times and preoperative serum creatinine level>70 μmol/L are all independent risk factors for postoperative complications,and more attention should be paid to the above factors to improve safety.
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