Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle
En Colombia la enfermedad renal crónica constituye una patología de alto costo, no sólo por el impacto económico que ella supone, sino por el deterioro de la calidad de vida de los pacientes(1). Si bien en adultos la principal causa de enfermedad renal crónica es la nefropatía diabética, en la pobla...
- Autores:
-
Castro Gómez, Martha Johanna
Lubinus Badillo, Federico
- Tipo de recurso:
- Fecha de publicación:
- 2011
- Institución:
- Universidad Autónoma de Bucaramanga - UNAB
- Repositorio:
- Repositorio UNAB
- Idioma:
- spa
- OAI Identifier:
- oai:repository.unab.edu.co:20.500.12749/12213
- Acceso en línea:
- http://hdl.handle.net/20.500.12749/12213
- Palabra clave:
- Medical sciences
Health sciences
Radiology
Diagnostic imaging
Percutaneous kidney biopsy
Disease
Ultrasound
Laboratory diagnostics
Ultrasound
Imaging system
Ciencias médicas
Radiología
Diagnóstico para imágenes
Diagnóstico de laboratorio
Ultrasonido
Sistema de imágenes
Ciencias de la salud
Biopsia renal percutánea
Enfermedad
Ecografía
- Rights
- openAccess
- License
- http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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|
dc.title.spa.fl_str_mv |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle |
dc.title.translated.spa.fl_str_mv |
Percutaneous renal biopsy guided by ultrasound experience at the Carlos Ardila Lulle clinic |
title |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle |
spellingShingle |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle Medical sciences Health sciences Radiology Diagnostic imaging Percutaneous kidney biopsy Disease Ultrasound Laboratory diagnostics Ultrasound Imaging system Ciencias médicas Radiología Diagnóstico para imágenes Diagnóstico de laboratorio Ultrasonido Sistema de imágenes Ciencias de la salud Biopsia renal percutánea Enfermedad Ecografía |
title_short |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle |
title_full |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle |
title_fullStr |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle |
title_full_unstemmed |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle |
title_sort |
Biopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila Lulle |
dc.creator.fl_str_mv |
Castro Gómez, Martha Johanna Lubinus Badillo, Federico |
dc.contributor.advisor.spa.fl_str_mv |
Rey Serrano, Juan José |
dc.contributor.author.spa.fl_str_mv |
Castro Gómez, Martha Johanna Lubinus Badillo, Federico |
dc.contributor.cvlac.spa.fl_str_mv |
Lubinus Badillo, Federico [0001475552] Rey Serrano, Juan José [0000265306] |
dc.contributor.googlescholar.spa.fl_str_mv |
Rey Serrano, Juan José [njpNpaUAAAAJ&hl=es&oi=ao] |
dc.contributor.orcid.spa.fl_str_mv |
Lubinus Badillo, Federico [0000-0003-1741-7016] Rey Serrano, Juan José [0000-0002-6946-2444 ] |
dc.contributor.scopus.spa.fl_str_mv |
Rey Serrano, Juan José [54793298100] |
dc.subject.keywords.eng.fl_str_mv |
Medical sciences Health sciences Radiology Diagnostic imaging Percutaneous kidney biopsy Disease Ultrasound Laboratory diagnostics Ultrasound Imaging system |
topic |
Medical sciences Health sciences Radiology Diagnostic imaging Percutaneous kidney biopsy Disease Ultrasound Laboratory diagnostics Ultrasound Imaging system Ciencias médicas Radiología Diagnóstico para imágenes Diagnóstico de laboratorio Ultrasonido Sistema de imágenes Ciencias de la salud Biopsia renal percutánea Enfermedad Ecografía |
dc.subject.lemb.spa.fl_str_mv |
Ciencias médicas Radiología Diagnóstico para imágenes Diagnóstico de laboratorio Ultrasonido Sistema de imágenes |
dc.subject.proposal.spa.fl_str_mv |
Ciencias de la salud Biopsia renal percutánea Enfermedad Ecografía |
description |
En Colombia la enfermedad renal crónica constituye una patología de alto costo, no sólo por el impacto económico que ella supone, sino por el deterioro de la calidad de vida de los pacientes(1). Si bien en adultos la principal causa de enfermedad renal crónica es la nefropatía diabética, en la población pediátrica lo son las enfermedades glomerulares(2). En este último punto la biopsia renal percutánea guiada por imagen se ha convertido en un procedimiento necesario y común debido a que representa una herramienta diagnostica invaluable, que permite un diagnóstico etiológico confiable; aunque actualmente ese tipo de procedimientos se pueden realizar guiados por tomografía y resonancia magnética, el mayor interés se ha centrado en el ultrasonido, que no solo es una modalidad libre de radiación ionizante que se puede realizar a la cabecera del paciente sino que resulta más económica. Otro escenario clínico específico en el que juega un papel importante es el seguimiento de pacientes trasplantados, procedimiento que cada vez se realiza con más frecuencia debido al refinamiento de las técnicas quirúrgicas y al desarrollo de medicamentos inmunosupresores más efectivos. Aunque se ha reportado que este procedimiento es seguro y eficaz, no está exento de complicaciones(3-6) que si bien son infrecuentes < 13%(3), representan gran morbilidad. Dichas complicaciones se han relacionado con la técnica, el tipo de dispositivo, el tamaño de la aguja, el número de pases necesarios para obtener una muestra adecuada y la experiencia del operador(3). |
publishDate |
2011 |
dc.date.issued.none.fl_str_mv |
2011 |
dc.date.accessioned.none.fl_str_mv |
2021-02-16T13:20:31Z |
dc.date.available.none.fl_str_mv |
2021-02-16T13:20:31Z |
dc.type.driver.none.fl_str_mv |
info:eu-repo/semantics/masterThesis |
dc.type.local.spa.fl_str_mv |
Tesis |
dc.type.redcol.none.fl_str_mv |
http://purl.org/redcol/resource_type/TM |
dc.identifier.uri.none.fl_str_mv |
http://hdl.handle.net/20.500.12749/12213 |
dc.identifier.instname.spa.fl_str_mv |
instname:Universidad Autónoma de Bucaramanga - UNAB |
dc.identifier.reponame.spa.fl_str_mv |
reponame:Repositorio Institucional UNAB |
dc.identifier.repourl.spa.fl_str_mv |
repourl:https://repository.unab.edu.co |
url |
http://hdl.handle.net/20.500.12749/12213 |
identifier_str_mv |
instname:Universidad Autónoma de Bucaramanga - UNAB reponame:Repositorio Institucional UNAB repourl:https://repository.unab.edu.co |
dc.language.iso.spa.fl_str_mv |
spa |
language |
spa |
dc.relation.references.spa.fl_str_mv |
1. León-García D OI. Guía para el manejo de la Enfermedad Renal Crónica Basada en la Evidencia (Colombia). Disponible en www.fedesalud.org.coConsultado Ago 2010. 2005. 2. Callis Bracons LM. [Renal biopsy and kidney diseases]. An Esp Pediatr2000 May;52(5):411-2 3. Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol2004 Jan;15(1):142-7. 4. Bogan ML, Kopecky KK, Kraft JL, Holladay AO, Filo RS, Leapman SB, et al. Needle biopsy of renal allografts: comparison of two techniques. Radiology1990 Jan;174(1):273-5. 5. Gastelbondo R MM. Etiología y estado actual de la insuficiencia renal crónica (IRC) en pediatría. Disponible en http://www.encolombia.com/medicina/pediatria/pediatria35400etiologia.htmConsultadoAgosto 2010. Rev Col Pediat2000;35(4). 6. Ortega M MJ, Gamarra G. Mortality in patients with chronic renal failure during the first 90 days of hemodialysis therapy. Acta Med Colomb2006;31(1):7. 7. Mostbeck GH, Wittich GR, Derfler K, Ulrich W, Walter RM, Herold C, et al. Optimal needle size for renal biopsy: in vitro and in vivo evaluation. Radiology1989 Dec;173(3):819-22. 8. Mladinich CR, Ackerman N, Berry CR, Buergelt CD, Longmate J. Evaluation and comparison of automated biopsy devices. Work in progress. Radiology1992 Sep;184(3):845-7. 9. Moulton JS, Moore PT. Coaxial percutaneous biopsy technique with automated biopsy devices: value in improving accuracy and negative predictive value. Radiology1993 Feb;186(2):515-22. 10. Poster RB, Jones DB, Spirt BA. Percutaneous pediatric renal biopsy: use of the biopsy gun. Radiology1990 Sep;176(3):725-7. 11. Gonzalez-Michaca L, Chew-Wong A, Soltero L, Gamba G, Correa-Rotter R. [Percutaneous kidney biopsy, analysis of 26 years: complication rate and risk factors; comment]. Rev Invest Clin2000 Mar-Apr;52(2):125-31. 12. Ball R. Needle (aspiration) biopsy. J Tenn Med Assoc1934;27:3. 13. Iversen P, Brun C. Aspiration biopsy of the kidney. Am J Med1951 Sep;11(3):324-30. 14. Kark RM, Muehrcke RC. Biopsy of kidney in prone position. Lancet1954 May 22;266(6821):1047-9. 15. Kark RM, Muehrcke RC, Pollak VE, Pirani CL, Kiefer JH. An analysis of five hundred percutaneous renal biopsies. AMA Arch Intern Med1958 Feb;101(2):439-51. 16. Fogazzi GB, Cameron JS. The early introduction of percutaneous renal biopsy in Italy. Kidney Int1999 Nov;56(5):1951-61. 17. Vernier RL, Good RA. Renal biopsy in children. Pediatrics1958 Dec;22(6):1033-4. 18. Vernier RL, Farquhar MG, Brunson JG, Good RA. Chronic renal disease in children; correlation of clinical findings with morphologic characteristics seen by light and electron microscopy. AMA J Dis Child1958 Sep;96(3):306-43. 19. Ruicastro MS, J. Faria, S. Belmira, A. Sampaio, S. Roquete, P. et al. Biopsia Renal Percutanea: Experiencia de 8 años. Acta Med Port2004;17:7. 20. Davis ID, Oehlenschlager W, O'Riordan MA, Avner ED. Pediatric renal biopsy: should this procedure be performed in an outpatient setting? Pediatr Nephrol1998 Feb;12(2):96-100. 21. Hopper KD, Abendroth CS, Sturtz KW, Matthews YL, Shirk SJ, Stevens LA. Blinded comparison of biopsy needles and automated devices in vitro: 2. Biopsy of medical renal disease. AJR Am J Roentgenol1993 Dec;161(6):1299-301. 22. Maya ID, Maddela P, Barker J, Allon M. Percutaneous renal biopsy: comparison of blind and real-time ultrasound-guided technique. Semin Dial2007 Jul-Aug;20(4):355-8. 23. Chan R, Common AA, Marcuzzi D. Ultrasound-guided renal biopsy: experience using an automated core biopsy system. Can Assoc Radiol J2000 Apr;51(2):107-13. 24. Ishikawa E, Nomura S, Hamaguchi T, Obe T, Inoue-Kiyohara M, Oosugi K, et al. Ultrasonography as a predictor of overt bleeding after renal biopsy. Clin Exp Nephrol2009 Aug;13(4):325-31. 25. Hergesell O, Felten H, Andrassy K, Kuhn K, Ritz E. Safety of ultrasound-guided percutaneous renal biopsy-retrospective analysis of 1090 consecutive cases. Nephrol Dial Transplant1998 Apr;13(4):975-7. 26. Whittier WL, Korbet SM. Renal biopsy: update. Curr Opin Nephrol Hypertens2004 Nov;13(6):661-5. 27. Loffroy R, Guiu B, Lambert A, Mousson C, Tanter Y, Martin L, et al. Management of post-biopsy renal allograft arteriovenous fistulas with selective arterial embolization: immediate and long-term outcomes. Clin Radiol2008 Jun;63(6):657-65. 28. Marwah DS, Korbet SM. Timing of complications in percutaneous renal biopsy: what is the optimal period of observation? Am J Kidney Dis1996 Jul;28(1):47-52. 29. Lin WC, Yang Y, Wen YK, Chang CC. Outpatient versus inpatient renal biopsy: a retrospective study. Clin Nephrol2006 Jul;66(1):17-24. 30. Cluzel P, Martinez F, Bellin MF, Michalik Y, Beaufils H, Jouanneau C, et al. Transjugular versus percutaneous renal biopsy for the diagnosis of parenchymal disease: comparison of sampling effectiveness and complications. Radiology2000 Jun;215(3):689-93. 31. Lefaucheur C, Nochy D, Bariety J. [Renal biopsy: procedures, contraindications, complications]. Nephrol Ther2009 Jul;5(4):331-9. 32. Racusen LC, Solez K, Colvin RB, Bonsib SM, Castro MC, Cavallo T, et al. The Banff 97 working classification of renal allograft pathology. Kidney Int1999 Feb;55(2):713-23. 33. Stratta P, Canavese C, Marengo M, Mesiano P, Besso L, Quaglia M, et al. Risk management of renal biopsy: 1387 cases over 30 years in a single centre. Eur J Clin Invest2007 Dec;37(12):954-63. 34. Nochy D, Lefaucheur C, Bariety J. [Renal biopsy: methods]. Nephrol Ther2009 Jul;5(4):314-30. 35. Guyton. AC HJ. Hemostasia y coagulación en la sangre. In: Hill MG, editor. Tratado de Fisiología Medica. 10 ed. España2001. p. 509-21. 36. Guyton. AC HJ. Micción, diureticos y enfermedades renales. In: Hill MG, editor. 10 ed. España2001. p. 443-61. 37. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr., et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA2003 May 21;289(19):2560-72. 38. Ravid M, Brosh D, Ravid-Safran D, Levy Z, Rachmani R. Main risk factors for nephropathy in type 2 diabetes mellitus are plasma cholesterol levels, mean blood pressure, and hyperglycemia. Arch Intern Med1998 May 11;158(9):998-1004. 39. Gavela T, Sanchez Bayle M, Gomez Mardones G, Gallego S, Martinez-Perez J, Moya MT. [Ecographic study of kidney size in children]. Nefrologia2006;26(3):325-9. 40. Ablett MJ, Coulthard A, Lee RE, Richardson DL, Bellas T, Owen JP, et al. How reliable are ultrasound measurements of renal length in adults? Br J Radiol1995 Oct;68(814):1087-9. 41. Emamian SA, Nielsen MB, Pedersen JF. Intraobserver and interobserver variations in sonographic measurements of kidney size in adult volunteers. A comparison of linear measurements and volumetric estimates. Acta Radiol1995 Jul;36(4):399-401. 42. Oyuela-Carrasco J, Rodriguez-Castellanos F, Kimura E, Delgado-Hernandez R, Herrera-Felix JP. [Renal length measured by ultrasound in adult mexican population]. Nefrologia2009;29(1):30-4. 43. Bakker J, Olree M, Kaatee R, de Lange EE, Moons KG, Beutler JJ, et al. Renal volume measurements: accuracy and repeatability of US compared with that of MR imaging. Radiology1999 Jun;211(3):623-8. 44. Cheong B, Muthupillai R, Rubin MF, Flamm SD. Normal values for renal length and volume as measured by magnetic resonance imaging. Clin J Am Soc Nephrol2007 Jan;2(1):38-45. 45. Padigala KK, Hartle JE, Kirchner HL, Schultz MF. Renal cortical thickness as a predictor of renal function and blood pressure status post renal artery stenting. Angiology2009 Dec-2010 Jan;60(6):719-24. 46. Chicaiza L. Fallas del Mercado de la Salud en Colombia: El caso de la insuficiencia renal crónica. Revista de Economía Institucional2005;12:18. 47. Republica de Colombia Mds. Resolución No. 8430. Colombia1993. 48. Nicholson ML, Wheatley TJ, Doughman TM, White SA, Morgan JD, Veitch PS, et al. A prospective randomized trial of three different sizes of core-cutting needle for renal transplant biopsy. Kidney Int2000 Jul;58(1):390-5. 49. Tung KT, Downes MO, O'Donnell PJ. Renal biopsy in diffuse renal disease--experience with a 14-gauge automated biopsy gun. Clin Radiol1992 Aug;46(2):111-3. 50. Mahoney MC, Racadio JM, Merhar GL, First MR. Safety and efficacy of kidney transplant biopsy: Tru-Cut needle vs sonographically guided Biopty gun. AJR Am J Roentgenol1993 Feb;160(2):325-6. 51. Mishra A, Tarsin R, Elhabbash B, Zagan N, Markus R, Drebeka S, et al. Percutaneous ultrasound-guided renal biopsy: A Libyan experience. Indian J Nephrol2010 Apr;20(2):76-9. 52. Eiro M, Katoh T, Watanabe T. Risk factors for bleeding complications in percutaneous renal biopsy. Clin Exp Nephrol2005 Mar;9(1):40-5. 53. Parichatikanond P, Chawanasuntorapoj R, Shayakul C, Choensuchon B, Vasuvattakul S, Vareesangthip K, et al. An analysis of 3,555 cases of renal biopsy in Thailand. J Med Assoc Thai2006 Aug;89 Suppl 2:S106-11. 54. Covic A, Schiller A, Volovat C, Gluhovschi G, Gusbeth-Tatomir P, Petrica L, et al. Epidemiology of renal disease in Romania: a 10 year review of two regional renal biopsy databases. Nephrol Dial Transplant2006 Feb;21(2):419-24. 55. Wiseman DA, Hawkins R, Numerow LM, Taub KJ. Percutaneous renal biopsy utilizing real time, ultrasonic guidance and a semiautomated biopsy device. Kidney Int1990 Aug;38(2):347-9. 56. Burstein DM, Korbet SM, Schwartz MM. The use of the automatic core biopsy system in percutaneous renal biopsies: a comparative study. Am J Kidney Dis1993 Oct;22(4):545-52. 57. Preda A, Van Dijk LC, Van Oostaijen JA, Pattynama PM. Complication rate and diagnostic yield of 515 consecutive ultrasound-guided biopsies of renal allografts and native kidneys using a 14-gauge Biopty gun. Eur Radiol2003 Mar;13(3):527-30. 58. Eisinger RP. Large studies of patients who have undergone renal biopsy indicate that those with hypertension are more prone to bleeding complications. Am J Kidney Dis1989 Jun;13(6):510. 59. Christensen J, Lindequist S, Knudsen DU, Pedersen RS. Ultrasound-guided renal biopsy with biopsy gun technique--efficacy and complications. Acta Radiol1995 May;36(3):276-9. 60. Yoshinari M, Suzuki R, Watanabe K, Katoh T, Watanabe T. How long is enough: length of renal needle biopsy specimen for histological diagnosis. Am J Nephrol2002 Jul-Aug;22(4):402. |
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Universidad Autónoma de Bucaramanga UNAB |
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Facultad Ciencias de la Salud |
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Especialización en Radiología e Imágenes Diagnósticas |
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Universidad Autónoma de Bucaramanga - UNAB |
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Rey Serrano, Juan José6a85095a-de37-42cf-8d36-37aa3a972409Castro Gómez, Martha Johannacd8999d3-cd6d-4d45-9cda-33eca8324e8aLubinus Badillo, Federico94a26d56-2a2a-4e53-8066-cad97e328b7dLubinus Badillo, Federico [0001475552]Rey Serrano, Juan José [0000265306]Rey Serrano, Juan José [njpNpaUAAAAJ&hl=es&oi=ao]Lubinus Badillo, Federico [0000-0003-1741-7016]Rey Serrano, Juan José [0000-0002-6946-2444 ]Rey Serrano, Juan José [54793298100]Floridablanca (Santander, Colombia)2021-02-16T13:20:31Z2021-02-16T13:20:31Z2011http://hdl.handle.net/20.500.12749/12213instname:Universidad Autónoma de Bucaramanga - UNABreponame:Repositorio Institucional UNABrepourl:https://repository.unab.edu.coEn Colombia la enfermedad renal crónica constituye una patología de alto costo, no sólo por el impacto económico que ella supone, sino por el deterioro de la calidad de vida de los pacientes(1). Si bien en adultos la principal causa de enfermedad renal crónica es la nefropatía diabética, en la población pediátrica lo son las enfermedades glomerulares(2). En este último punto la biopsia renal percutánea guiada por imagen se ha convertido en un procedimiento necesario y común debido a que representa una herramienta diagnostica invaluable, que permite un diagnóstico etiológico confiable; aunque actualmente ese tipo de procedimientos se pueden realizar guiados por tomografía y resonancia magnética, el mayor interés se ha centrado en el ultrasonido, que no solo es una modalidad libre de radiación ionizante que se puede realizar a la cabecera del paciente sino que resulta más económica. Otro escenario clínico específico en el que juega un papel importante es el seguimiento de pacientes trasplantados, procedimiento que cada vez se realiza con más frecuencia debido al refinamiento de las técnicas quirúrgicas y al desarrollo de medicamentos inmunosupresores más efectivos. Aunque se ha reportado que este procedimiento es seguro y eficaz, no está exento de complicaciones(3-6) que si bien son infrecuentes < 13%(3), representan gran morbilidad. Dichas complicaciones se han relacionado con la técnica, el tipo de dispositivo, el tamaño de la aguja, el número de pases necesarios para obtener una muestra adecuada y la experiencia del operador(3).1. Planteamiento del problema 3 2. Marco teórico 4 3. Objetivos 14 3.1 Objetivo general 14 3.2 Objetivos específicos 14 4. Metodología 15 4.1 Tipo de estudio 15 4.2 Población 15 4.3 Criterios de inclusión y exclusión 15 4.4 Variables 15 4.5 Recolección de la información 17 4.6 Técnica del procedimiento 18 4.7 Aspectos éticos 19 5. Resultados 20 6. Discusión 27 7. Conclusiones 31 8. Limitaciones 31 9. Bibliografía 32 10. Anexos 36 10.1 ANEXO 1 36EspecializaciónIn Colombia, chronic kidney disease is a high-cost pathology, not only because of the economic impact it entails, but also because of the deterioration in the quality of life of patients (1). Although in adults the main cause of chronic kidney disease is diabetic nephropathy, in the pediatric population it is glomerular diseases (2). In this last point, the image-guided percutaneous renal biopsy has become a necessary and common procedure because it represents an invaluable diagnostic tool that allows a reliable etiological diagnosis; Although these types of procedures can currently be performed guided by tomography and magnetic resonance imaging, the greatest interest has focused on ultrasound, which is not only an ionizing radiation-free modality that can be performed at the patient's bedside but is also more economical . Another specific clinical scenario in which it plays an important role is the follow-up of transplanted patients, a procedure that is being performed more and more frequently due to the refinement of surgical techniques and the development of more effective immunosuppressive drugs. Although this procedure has been reported to be safe and effective, it is not without complications (3-6) which, although they are infrequent <13% (3), represent great morbidity. These complications have been related to the technique, the type of device, the size of the needle, the number of passes required to obtain an adequate sample, and the experience of the operator (3).application/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Abierto (Texto Completo)info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Atribución-NoComercial-SinDerivadas 2.5 ColombiaBiopsia renal percutánea guiada por ecografía experiencia en la clínica Carlos Ardila LullePercutaneous renal biopsy guided by ultrasound experience at the Carlos Ardila Lulle clinicEspecialistas en Radiología e Imágenes DiagnósticasUniversidad Autónoma de Bucaramanga UNABFacultad Ciencias de la SaludEspecialización en Radiología e Imágenes Diagnósticasinfo:eu-repo/semantics/masterThesisTesishttp://purl.org/redcol/resource_type/TMMedical sciencesHealth sciencesRadiologyDiagnostic imagingPercutaneous kidney biopsyDiseaseUltrasoundLaboratory diagnosticsUltrasoundImaging systemCiencias médicasRadiologíaDiagnóstico para imágenesDiagnóstico de laboratorioUltrasonidoSistema de imágenesCiencias de la saludBiopsia renal percutáneaEnfermedadEcografía1. 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Am J Nephrol2002 Jul-Aug;22(4):402.ORIGINAL2011_Tesis_Martha_Johanna_Castro_Gómez.pdf2011_Tesis_Martha_Johanna_Castro_Gómez.pdfTesisapplication/pdf1325121https://repository.unab.edu.co/bitstream/20.500.12749/12213/1/2011_Tesis_Martha_Johanna_Castro_G%c3%b3mez.pdf076e831ca7db956fbe70daa0600f4186MD51open accessTHUMBNAIL2011_Tesis_Martha_Johanna_Castro_Gómez.pdf.jpg2011_Tesis_Martha_Johanna_Castro_Gómez.pdf.jpgIM Thumbnailimage/jpeg6315https://repository.unab.edu.co/bitstream/20.500.12749/12213/3/2011_Tesis_Martha_Johanna_Castro_G%c3%b3mez.pdf.jpg76d84ee966e38f258dde2327997afd50MD53open accessLICENSElicense.txtlicense.txttext/plain; charset=utf-81748https://repository.unab.edu.co/bitstream/20.500.12749/12213/2/license.txt8a4605be74aa9ea9d79846c1fba20a33MD52open access20.500.12749/12213oai:repository.unab.edu.co:20.500.12749/122132022-11-21 21:45:13.783open accessRepositorio Institucional | Universidad Autónoma de Bucaramanga - UNABrepositorio@unab.edu.coTk9URTogUExBQ0UgWU9VUiBPV04gTElDRU5TRSBIRVJFClRoaXMgc2FtcGxlIGxpY2Vuc2UgaXMgcHJvdmlkZWQgZm9yIGluZm9ybWF0aW9uYWwgcHVycG9zZXMgb25seS4KCk5PTi1FWENMVVNJVkUgRElTVFJJQlVUSU9OIExJQ0VOU0UKCkJ5IHNpZ25pbmcgYW5kIHN1Ym1pdHRpbmcgdGhpcyBsaWNlbnNlLCB5b3UgKHRoZSBhdXRob3Iocykgb3IgY29weXJpZ2h0Cm93bmVyKSBncmFudHMgdG8gRFNwYWNlIFVuaXZlcnNpdHkgKERTVSkgdGhlIG5vbi1leGNsdXNpdmUgcmlnaHQgdG8gcmVwcm9kdWNlLAp0cmFuc2xhdGUgKGFzIGRlZmluZWQgYmVsb3cpLCBhbmQvb3IgZGlzdHJpYnV0ZSB5b3VyIHN1Ym1pc3Npb24gKGluY2x1ZGluZwp0aGUgYWJzdHJhY3QpIHdvcmxkd2lkZSBpbiBwcmludCBhbmQgZWxlY3Ryb25pYyBmb3JtYXQgYW5kIGluIGFueSBtZWRpdW0sCmluY2x1ZGluZyBidXQgbm90IGxpbWl0ZWQgdG8gYXVkaW8gb3IgdmlkZW8uCgpZb3UgYWdyZWUgdGhhdCBEU1UgbWF5LCB3aXRob3V0IGNoYW5naW5nIHRoZSBjb250ZW50LCB0cmFuc2xhdGUgdGhlCnN1Ym1pc3Npb24gdG8gYW55IG1lZGl1bSBvciBmb3JtYXQgZm9yIHRoZSBwdXJwb3NlIG9mIHByZXNlcnZhdGlvbi4KCllvdSBhbHNvIGFncmVlIHRoYXQgRFNVIG1heSBrZWVwIG1vcmUgdGhhbiBvbmUgY29weSBvZiB0aGlzIHN1Ym1pc3Npb24gZm9yCnB1cnBvc2VzIG9mIHNlY3VyaXR5LCBiYWNrLXVwIGFuZCBwcmVzZXJ2YXRpb24uCgpZb3UgcmVwcmVzZW50IHRoYXQgdGhlIHN1Ym1pc3Npb24gaXMgeW91ciBvcmlnaW5hbCB3b3JrLCBhbmQgdGhhdCB5b3UgaGF2ZQp0aGUgcmlnaHQgdG8gZ3JhbnQgdGhlIHJpZ2h0cyBjb250YWluZWQgaW4gdGhpcyBsaWNlbnNlLiBZb3UgYWxzbyByZXByZXNlbnQKdGhhdCB5b3VyIHN1Ym1pc3Npb24gZG9lcyBub3QsIHRvIHRoZSBiZXN0IG9mIHlvdXIga25vd2xlZGdlLCBpbmZyaW5nZSB1cG9uCmFueW9uZSdzIGNvcHlyaWdodC4KCklmIHRoZSBzdWJtaXNzaW9uIGNvbnRhaW5zIG1hdGVyaWFsIGZvciB3aGljaCB5b3UgZG8gbm90IGhvbGQgY29weXJpZ2h0LAp5b3UgcmVwcmVzZW50IHRoYXQgeW91IGhhdmUgb2J0YWluZWQgdGhlIHVucmVzdHJpY3RlZCBwZXJtaXNzaW9uIG9mIHRoZQpjb3B5cmlnaHQgb3duZXIgdG8gZ3JhbnQgRFNVIHRoZSByaWdodHMgcmVxdWlyZWQgYnkgdGhpcyBsaWNlbnNlLCBhbmQgdGhhdApzdWNoIHRoaXJkLXBhcnR5IG93bmVkIG1hdGVyaWFsIGlzIGNsZWFybHkgaWRlbnRpZmllZCBhbmQgYWNrbm93bGVkZ2VkCndpdGhpbiB0aGUgdGV4dCBvciBjb250ZW50IG9mIHRoZSBzdWJtaXNzaW9uLgoKSUYgVEhFIFNVQk1JU1NJT04gSVMgQkFTRUQgVVBPTiBXT1JLIFRIQVQgSEFTIEJFRU4gU1BPTlNPUkVEIE9SIFNVUFBPUlRFRApCWSBBTiBBR0VOQ1kgT1IgT1JHQU5JWkFUSU9OIE9USEVSIFRIQU4gRFNVLCBZT1UgUkVQUkVTRU5UIFRIQVQgWU9VIEhBVkUKRlVMRklMTEVEIEFOWSBSSUdIVCBPRiBSRVZJRVcgT1IgT1RIRVIgT0JMSUdBVElPTlMgUkVRVUlSRUQgQlkgU1VDSApDT05UUkFDVCBPUiBBR1JFRU1FTlQuCgpEU1Ugd2lsbCBjbGVhcmx5IGlkZW50aWZ5IHlvdXIgbmFtZShzKSBhcyB0aGUgYXV0aG9yKHMpIG9yIG93bmVyKHMpIG9mIHRoZQpzdWJtaXNzaW9uLCBhbmQgd2lsbCBub3QgbWFrZSBhbnkgYWx0ZXJhdGlvbiwgb3RoZXIgdGhhbiBhcyBhbGxvd2VkIGJ5IHRoaXMKbGljZW5zZSwgdG8geW91ciBzdWJtaXNzaW9uLgo= |