Safety and tissue yield for percutaneous native kidney biopsy according to practitioner and ultrasound technique

Abstract

BackgroundAlthough percutaneous renal biopsy remains an essential tool in the diagnosis and treatment of renal diseases, in recent times the traditional procedure of nephrologists has been performed by non-nephrologists rather than nephrologists at many institutions. The present study assessed the safety and adequacy of tissue yield during percutaneous renal biopsy according to practitioners and techniques based on ultrasound.MethodsThis study included 658 native renal biopsies performed from 2005 to 2010 at a single centre. The biopsies were performed by nephrologists or expert ultrasound radiologists using the ultrasound-marked blind or real-time ultrasound-guided techniques.ResultsA total of 271 ultrasound-marked blind biopsies were performed by nephrologists, 170 real-time ultrasound-guided biopsies were performed by nephrologists, and 217 real-time ultrasound-guided biopsies were performed by radiologists during the study period. No differences in post-biopsy complications such as haematoma, need for transfusion and intervention, gross haematuria, pain, or infection were observed among groups. Glomerular numbers of renal specimens from biopsies performed by nephrologists without reference to any technique were higher than those obtained from real-time ultrasound-guided biopsies performed by expert ultrasound radiologists.ConclusionsPercutaneous renal biopsy performed by nephrologists was not inferior to that performed by expert ultrasound radiologists as related to specimen yield and post-biopsy complications.

The Native Kidney Biopsy

“…One retrospective study found no difference in diagnostic yield or complications (hematoma, need for transfusion, gross hematuria, pain, or infection) between ultrasoundmarked, blind PRBs performed by nephrologists (n=271) and real-time/ultrasound-guided PRBs performed by nephrologists (n=170) or radiologists (n=217) (30). It should go without saying that a kidney biopsy should only be done by someone skillful in performing the procedure and when the tissue can be processed and interpreted by those with the skills necessary to do so (14).…”

Identification of a novel GLA mutation (Y88C) in a Korean family with Fabry nephropathy: a case report

“…Percutaneous renal biopsy was done by nephrologists under ultrasonographic guidance using an automated biopsy gun as previously described [8]. Histopathologic diagnosis on each sample was made comprehensively based on all clinical data and pathologic findings.…”

Resolution of proteinuria after transarterial embolization of aberrant renal artery in a patient with focal segmental glomerulosclerosis

“…Ultrasound-guided percutaneous renal biopsy (PRB) is an important technique for making diagnosis and obtaining prognostic information for the treatment of glomerular diseases [1,2]. Although PRB has some complications mainly related to bleeding [2,3], life-threatening complications of PRB occur in only \0.1 % of cases [4][5][6].…”