Percutaneous ultrasound-guided renal biopsy; A comparison of axial vs. sagittal probe location

Abstract

Background. Renal biopsy is an important method for diagnosis of renal parenchymal abnormalities. Here, we compare the effectiveness and complications of percutaneous ultrasoundguided renal biopsy using axial vs. sagittal probe locations.Methods. In a cross-sectional survey, in 2012, patients with a nephrologist order were biopsied by a radiology resident. Renal biopsy was done on 15 patients using axial (A group) and the same number of biopsies done with sagittal probe location (S group). The two groups were compared in term of the yields and complications of each method.Results. In the A group, the ratio of glomeruli gathered to the number of obtained samples was significantly higher than in the S group. Nine patients in the A group (60%) required only two samplings, whereas 66.7% in the S group required more than two attempts. Microscopic hematuria was more common in the A; conversely, gross hematuria was less common in the A group. Meagre hematomas were more frequent in the S group .When compared with hemoglobin level before biopsy, its level 24 hours after biopsy was similar within groups.Conclusion. Our study shows that percutaneous ultrasound-guided renal biopsy using axial probe provides better yield with fewer efforts and fewer serious complications.

Glomeruli Count and Arterial Injury in Real-Time Ultrasound-Guided Needle Kidney Biopsy Specimens: Adequacy of Three Approaches for Pig Kidneys

“…Regarding ultrasound-guided needle kidney biopsy, different approaches may not be directly related to the risk of bleeding. The safety of different approaches in kidney biopsies is yet to be established because of contrasting views [14, 20, 28]; however, it should be noted that these reports focus on bleeding as an outcome. The risk of bleeding and hematoma is associated with many factors, including sex, age, body size, kidney disease, biopsy needle size, serum creatinine level, and presence of acute kidney injury or hypertension [9, 10, 29].…”

“…Three main approaches to kidney biopsy are commonly usednamely, puncturing the lower pole toward the cranial side, puncturing the lower pole toward the caudal side, and puncturing the surface cortex of the lower pole of the kidney. To date, several reports have presented the advantages of each approach [14][15][16][17] and have evaluated their postoperative bleeding risk. However, these studies were not performed on the same kidney; it is not ethical in clinical practice to use different approaches at the same time on a single individual.…”

Biopsia de injerto renal con técnica tangencial mediante aguja de corte guiada por ultrasonido

“…6,8 Se considera un abordaje no-tangencial aquel que no cumple con los criterios previamente mencionados. 2,[7][8][9] Existen bajas tasas de complicaciones con el abordaje tangencial cortical, diversos estudios han mostrado rangos de 0.7% en las complicaciones hemorrágicas que requirieron transfusión; sin embargo, de éstas las más frecuentes son las complicaciones mínimas, por ejemplo, la hematuria macroscópica con cifras que van de 0.06 a 13%, 8 y con variaciones de 3 a 8% en otros estudios. 1,6,10…”