A Study of Diagnostic Yield, Efficacy and Complications of Ultrasound Guided Renal Biopsy in Different Renal Pathologies

Abstract

Introduction: Renal biopsy is an integral part of modern nephrology practice, being indicated in renal diseases in both native and transplanted kidneys. The purpose of this study was to automated biopsy gun.

Methods: This was a prospective cross-sectional study involving 184 patients including renal transplant recipients. These patients, with new onset renal symptoms or deteriorating renal function post-transplant, underwent freehand real time ultrasound guided renal biopsy with 18 gauge automated biopsy gun. The diagnostic yield, pathological and immunohistochemistry diagnosis and complications of the procedure were analyzed.

Results: 184 patients underwent the ultrasound guided biopsy, 17 were renal transplant recipients. Male and female ratio was almost equal (51.1% and 48.9%, respectively). Most patients were in the age group of 20-40 years. Most cases presented clinically with nephrotic syndrome (38.04%), followed by an equal number of lupus nephritis and nonnephrotic range proteinuria. The average number of glomeruli in the biopsy tissue was 11.8 per specimen. The average length of biopsy tissue was 1.15 cm in native kidneys and 0.9 cm in transplant kidneys. Renal biopsy yielded a pathological diagnosis in 97.2% of cases, with adequate sample for diagnosis in 98.9% of cases. Major life threatening complication was noted in a single patient. Rest of the patients showed minor or no complications.

Conclusion: Ultrasound guided percutaneous biopsy with automated biopsy gun is modality of choice for renal biopsy since it has the greatest yield, highest efficacy and least serious complication rates.