Free-hand, ultrasound-guided percutaneous renal biopsy: experience from a single operator

Percutaneous renal biopsy is a useful diagnostic procedure for many renal diseases. The experience with ultrasound-guided percutaneous renal biopsy from a single operator was reviewed to identify the possible risk factors of complications after the procedure.

From 1995 to 1998, 203 biopsies (141 on native kidneys with 14G needles, 62 on transplant kidneys with 18G needles) were performed on 186 individuals as clinically indicated. The biopsy tissue specimen was adequate for histological diagnosis in 96.4% of the biopsies performed. IgA nephropathy followed by lupus nephritis were the most frequent diagnoses in our locality. Haematuria was the most common complication observed: mild bleeding occurred in 4.5%, while major complications (those that required blood transfusion or other intervention) were encountered in 1.5% of patients. Impaired renal function was identified as the single most important risk factor of bleeding complication after renal biopsy, while the presence of systemic hypertension or nephrotic syndrome did not increase the risk of bleeding. There was no correlation between bleeding and the type of renal pathology or the number of needle passes. Continuous haematuria may result from blood clot retention in the bladder. Over 97% of the cases were discharged from hospital within 48 h.

We conclude that ultrasound-guided renal biopsy remains a safe, fast, and accurate procedure for the definitive investigation of renal diseases.