Percutaneous renal biopsy in the district general hospital

This paper reports a retrospective study of the clinical value of percutaneous renal biopsy in secondary referral centres. Between 1984-90, 205 patients over the age of 16 had 218 biopsies at three district general hospitals. Adequate tissue was obtained in 194 patients (95%, 89% of the biopsies). Significant complications occurred in only four patients. In 170 patients (83%) the biopsy yielded information of diagnostic and prognostic value and influenced management. The main indications for biopsy were nephrotic syndrome, in 63 patients, and chronic renal failure, in 58 patients. The most frequent findings were minimal change disease, focal segmental glomerulosclerosis, IgA nephropathy, membranous glomerulonephritis and mesangiocapillary glomerulonephritis. The most obvious association between indication and histology was between haematuria and IgA nephropathy. Percutaneous renal biopsy in the district general hospital in patients selected by a nephrologist and performed by experienced or supervised operators is a safe procedure. There is a high yield of renal tissue which is of clinical value in patient care.