Real-time ultrasound guided renal biopsy in diffuse renal disease: 114 consecutive cases

Introduction: Renal biopsy is a useful diagnostic procedure. In developing countries, two techniques of renal biopsy, blind percutaneous renal biopsy and real-time ultrasound-guided percutaneous renal biopsy, have been performed. The majority of studies compared these using different types and sizes of biopsy needle. The aim of this study was to compare both techniques in resource constraint country. Method: We reviewed renal biopsy database, between 1 January 2014 to 30 June 2017. The primary outcome was the total number of glomeruli. The other outcomes were tissue adequacy and bleeding complications. We also analyzed multivariable logistic regression to find factors associated with tissue adequacy and bleeding complications. Result: Of the 204 renal biopsies, 100 were blind percutaneous renal biopsy and 104 real-time ultrasound-guided percutaneous renal biopsy. The number of native renal biopsies was 169 (82.8%). Baseline characteristics of two groups were comparable. The mean number of total glomeruli from real-time ultrasound-guided percutaneous renal biopsy was significantly more than blind percutaneous renal biopsy (20.8 ± 12.1 vs 16.0 ± 13.0, p = 0.001). The real-time ultrasound-guided percutaneous renal biopsy obtained more adequate tissues than blind percutaneous renal biopsy (45.2% vs 16%, p < 0.001) and was the only factor associated with adequate tissue. Moreover, 16 renal biopsies from blind percutaneous renal biopsy obtained inadequate tissue. The overall bleeding complications were not statistically different. We found being female, lower eGFR and lower hematocrit were associated with bleeding complications. Conclusion: In comparison with blind percutaneous renal biopsy, real-time ultrasound-guided percutaneous renal biopsy obtained more adequate tissue and number of glomeruli. While the complications of both were comparable. We encourage to practice and perform real-time ultrasound-guided percutaneous renal biopsy in resource constraint countries.

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Percutaneous Renal Biopsy: Comparison of Blind and Real-time Ultrasound Guided Technique

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v16i1.19369 ◽

2018 ◽

Vol 16 (1) ◽

pp. 66-72 ◽

Cited By ~ 2

Author(s):

Anil Pokhrel ◽

Rajendra Kumar Agrawal ◽

Anil Baral ◽

Ajaya Rajbhandari ◽

Rajani Hada

Keyword(s):

Renal Biopsy ◽

Real Time ◽

Randomized Study ◽

Bleeding Complications ◽

Renal Diseases ◽

Ultrasound Guided ◽

Macroscopic Hematuria ◽

Percutaneous Renal Biopsy ◽

Significant Difference ◽

Perinephric Hematoma

Background: Percutaneous renal biopsy is performed for diagnosis and prediction of prognosis of renal diseases. Adequacy of tissue and clinically significant bleeding are the main issues of the procedure. We aimed to compare these issues in renal biopsy by blind and real time ultrasound guided technique.Methods: It was a cross sectional, randomized study conducted between June 2016 to December 2016. In blind technique, marking for biopsy was done by ultrasound. Two attempts were performed for all and more if tissue was inadequate. Patients kept in bed rest for 24 hours, observed for post procedure hematuria and ultrasound done at 6 hours and 24 hours to diagnose perinephric hematoma.Results: Total 75 biopsies (blind = 37 and Ultrasound -guided = 38) were evaluated. Blind and Ultrasound-guided technique had significant difference of number of attempt (mean±SD) 2.4±0.6 and 2.1±0.3 (p<0.01) respectively with no difference of number of glomeruli in light microscopy. Bleeding complications were macroscopic hematuria (11(30%)vs15(40%)) and perinephric hematoma ( 5(13.5%)vs3(7.9%)) in blind and Ultrasound-guided technique respectively with no significant difference. Those patients who developed perinephric hematoma was observed in all at 6 hours.Conclusions: Ultrasound-guided technique of percutaneous renal biopsy is superior with fewer attempts and equivalent in adequacy of tissue and bleeding complication than blind technique.

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Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications

Clinical Kidney Journal ◽

10.1093/ckj/sfv012 ◽

2015 ◽

Vol 8 (2) ◽

pp. 151-156 ◽

Cited By ~ 38

Author(s):

N. Prasad ◽

S. Kumar ◽

R. Manjunath ◽

D. Bhadauria ◽

A. Kaul ◽

...

Keyword(s):

Renal Biopsy ◽

Real Time ◽

Ultrasound Guided ◽

Percutaneous Renal Biopsy ◽

Biopsy Complications

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MP070COMPARISON OF 4-DIMENSIONAL REAL TIME ULTRASOUND GUIDED PER-CUTANEOUS RENAL BIOPSY WITH THE 2-DIMENSIONAL ULTRASOUND GUIDED PROCEDURE

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfw183.02 ◽

2016 ◽

Vol 31 (suppl_1) ◽

pp. i366-i366

Author(s):

Varun Kumar Bandi ◽

Venkata Sai ◽

Ram Prasad Elumalai ◽

P. Soundararajan

Keyword(s):

Renal Biopsy ◽

Real Time ◽

Ultrasound Guided

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Real time Ultrasound Guided Percutaneous Native Renal Biopsy- Approach, Safety and Complications

Journal of BP Koirala Institute of Health Sciences ◽

10.3126/jbpkihs.v1i2.22080 ◽

2018 ◽

Vol 1 (2) ◽

pp. 57-64

Author(s):

Ashok Raj Pant ◽

R.K. Rauniyar ◽

M.K. Gupta ◽

B. Bartaula ◽

M. Subedi ◽

...

Keyword(s):

Blood Pressure ◽

Renal Biopsy ◽

Diastolic Blood Pressure ◽

Real Time ◽

Clinical Laboratory ◽

Univariate Analysis ◽

Multivariate Logistic Regression Analysis ◽

Safe Procedure ◽

Ultrasound Guided ◽

Percutaneous Renal Biopsy

Introduction: Ultrasound guided percutaneous renal biopsy (PRB) is a relatively safe procedure; however, life threatening complications may occur even in current practice. There has been considerable decrease in the risk associated with percutaneous renal biopsy (PRB) in last few decades due to modifications in the biopsy needle as well as advancement in the image guidance. Objectives: To determine the complications and efficacy and to determine relationship between the clinical/ laboratory findings with rate of complications. Material and methods: We retrospectively evaluated hospital records of total of 150 patients who underwent PRB between September 2014 to August 2016 in the department of Radio diagnosis and Imaging at B. P. Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal. The renal biopsies had been performed with the current automated biopsy gun under real-time ultrasound guidance. The collected data were entered in MS excel. Results: In the total 150 patients, the efficacy (adequacy of the sample) of the procedure was 97.3%. The complications were seen in 13 cases (8.6 %). Five out of these complications were major with 2 cases requiring blood transfusion. The univariate analysis demonstrated the risk factors for developing complications as follows: low platelet count, prolong PT/INR, elevated Blood Urea Nitrogen (BUN) and serum creatinine value and elevated systolic and diastolic blood pressure. However, elevated diastolic blood pressure and prolong PT/INR were associated with complications in multivariate logistic regression analysis. Conclusions: The percutaneous renal biopsy is the safe and efficacious procedure to establish histological diagnosis of renal parenchymal disease.

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Simulation of real-time ultrasound-guided renal biopsy

Kidney International ◽

10.1038/ki.2010.213 ◽

2010 ◽

Vol 78 (7) ◽

pp. 705-707 ◽

Cited By ~ 16

Author(s):

Michal Mrug ◽

John J. Bissler

Keyword(s):

Renal Biopsy ◽

Real Time ◽

Ultrasound Guided

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Predictors of perirenal haematoma post-percutaneous ultrasound-guided renal biopsy

Journal of International Medical Research ◽

10.1177/03000605211058377 ◽

2021 ◽

Vol 49 (11) ◽

pp. 030006052110583

Author(s):

Shihao Xu ◽

Bing Xiong ◽

Saifeng Lin ◽

Qiao Li ◽

Lei Wang ◽

...

Keyword(s):

Risk Factors ◽

Prospective Study ◽

Renal Biopsy ◽

Real Time ◽

Binary Logistic Regression ◽

Binary Logistic Regression Analysis ◽

Ultrasound Guided ◽

Factors Associated ◽

A Prospective Study ◽

Haematoma Formation

Objective To perform a prospective study to determine the risk factors associated with perirenal haematoma development after percutaneous renal biopsy (PRB). Methods This multivariate prospective study collected demographic and clinical data from all consecutive adult patients that underwent real-time ultrasound-guided PRB of native kidneys. All biopsies were performed by two well-trained ultrasound physicians using 16G biopsy needles. Routine renal ultrasounds were performed within 12–24 h after biopsies in order to observe post-biopsy perirenal haematoma formation. Patients were stratified based on the occurrence of post-biopsy haematoma development. Results This prospective study enrolled 218 patients and stratified them into a haematoma group ( n = 126) and a non-haematoma group ( n = 92). Binary logistic regression analysis identified female patients (odds ratio [OR] 1.990; 95% confidence interval [CI] 1.125, 3.521), patients with a body mass index (BMI) ≥28 kg/m2 (OR 2.660; 95% CI 1.097, 6.449) and patients with immediate post-biopsy active bleeding (IPAB) (OR 2.572; 95% CI 1.422, 4.655) as being more likely to have perirenal haematoma after real-time ultrasound guided PRB of native kidneys. Conclusion Female sex, a BMI ≥28 kg/m2 and IPAB were risk factors for perirenal haematoma after real-time ultrasound-guided PRB of native kidneys.

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