Percutaneous renal biopsy: comparison of manual and automated puncture techniques with native and transplanted kidneys

摘要

The diagnostic usefulness of the biopsy cylinder and biopsy-induced complications were investigated for 458 percutaneous renal biopsies (315 native, 143 transplant kidneys) on 339 patients (average age, 44.6±18.5 years) under two different biopsy regimes (regime I, manual biopsy technique with Tru-Cut needle, 14 gauge; regime II, automated biopsy technique using a Biopty instrument and adapted biopsy needle, 18 gauge).In 435 (95) of the biopsies, kidney tissue with 9.09±5.28 glomeruli was obtained (regime I, 93.5, 9.5±4.9 glomeruli; regime II, 96.5, 8.7+5.6 glomeruli;p>0.05). Neither with native nor with transplant kidneys was there any evident advantage for a particular regime in terms of the diagnostic usefulness of the cylinder. Bleeding complications (perirenal haemat-omas, bleeding into the renal pelvis, blood clots in the urinary bladder) were observed in 69 (15.1) patients (regime I, 15.6; regime II, 14.6P>0.05). Clinically relevant bleeding complications were significantly rarer under regime II (9.1versus 3.5;P<0.05). Complications were less frequent with transplant than with native kidneys (12.6versus 16.2). Doppler sonography of the biopsied transplant kidneys revealed arteriovenous fistulae in nine cases (6.3; regime I, 8.0; regime II, 5.4).In general, use of an automated biopsy instrument and a thinner biopsy needle reduced the number of significant complications following percutaneous renal biopsy, while achieving comparably diagnostic effica