Background: Renal biopsy (RB) is necessary for the diagnosis, prognosis, and therapy guidance of native kidney diseases. Few studies have compared outcomes of RB procedures. We retrospectively compared the safety and efficiency of five biopsy procedures. Methods: The number of glomeruli on light microscopy (LM) and on immunofluorescence (IF) and serious adverse events following RB performed in five nephrology units (C1–C5) were collected. C1 performed ultrasound (US) assessment before RB and used a 14-gauge core-cutting needle biopsy gun, C2 US guidance and a 14-gauge needle, C3 tomodensitometry guidance and a 14-gauge needle, C4 US guidance and a 16-gauge needle, and C5 tomodensitometry guidance and a 16-gauge needle. Results: RB was performed in 943 adults between January 2006 and July 2010. Serious adverse events occurred in 1.5% of biopsies. The complication rate was not different between nephrology units. The mean number of glomeruli on biopsy was 14.2 ± 8.6 with LM and 4.4 ± 3.3 on IF. It was different according to the nephrology unit for LM (p = 0.01) and for IF (p < 0.001). The number of failed biopsies was influenced by the nephrology unit and radiological guidance technique, favoring real-time US guidance. Failed biopsies using US or tomodensitometry assessment before RB was certainly due to kidney imprecise localization since it was often non-renal tissue sampling. At least 10 glomeruli were found in 69% of biopsies on LM. This rate varied according to the nephrology unit (p = 0.004) and was higher when 14-gauge needles were used in comparison with 16-gauge needles. Conclusion: RB is safe regardless of the technical procedure, but radiological guidance and needle size influence the efficiency of biopsies.

Bollée G, Martinez F, Moulin B, et al: Renal biopsy practice in France: results of a nationwide study. Nephrol Dial Transplant 2010;25:3579–3585.
Hergesell O, Felten H, Andrassy K, Kühn K, Ritz E: Safety of ultrasound-guided percutaneous renal biopsy-retrospective analysis of 1,090 consecutive cases. Nephrol Dial Transplant 1998;13:975–977.
Manno C, Strippoli GF, Arnesano L, et al: Predictors of bleeding complications in percutaneous ultrasound-guided renal biopsy. Kidney Int 2004;66:1570–1577.
Stratta P, Canavese C, Marengo M, et al: Risk management of renal biopsy: 1,387 cases over 30 years in a single centre. Eur J Clin Invest 2007;37:954–963.
Eiro M, Katoh T, Watanabe T: Risk factors for bleeding complications in percutaneous renal biopsy. Clin Exp Nephrol 2005;9:40–45.
Mendelssohn DC, Cole EH: Outcomes of percutaneous kidney biopsy, including those of solitary native kidneys. Am J Kidney Dis 1995;26:580–585.
Shidham GB, Siddiqi N, Beres JA, et al: Clinical risk factors associated with bleeding after native kidney biopsy. Nephrology (Carlton) 2005;10:305–310.
Nicholson ML, Wheatley TJ, Doughman TM, et al: A prospective randomized trial of three different sizes of core-cutting needle for renal transplant biopsy. Kidney Int 2000;58:390–395.
Cozens NJ, Murchison JT, Allan PL, Winney RJ: Conventional 15-guage needle technique for renal biopsy compared with ultrasound-guided spring-loaded 18-gauge needle biopsy. Br J Radiol 1992;65:594–597.
Kim D, Kim HK, Shin G, et al: A randomized, prospective, comparative study of manual and automated renal biopsies. Am J Kidney Dis 1998;32:426–431.
Maya ID, Maddela P, Barker J, et al: Percutaneous renal biopsy: comparison of blind and real-time ultrasound-guided technique. Semin Dial 2007;20:355–358.
Weening JJ, D’Agati VD, Schwartz MM, et al: The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol 2004;15:241–250.
Hoy WE, Samuel T, Hughson MD, Nicol JL, Bertram JF: How many glomerular profiles must be measured to obtain reliable estimates of mean glomerular areas in human renal biopsies? J Am Soc Nephrol 2006;17:556–563.
Tervaert TW, Mooyaart AL, Amann K, et al: Pathologic classification of diabetic nephropathy. J Am Soc Nephrol 2010;21:556–563.
Donovan KL, Thomas DM, Wheeler DC, et al: Experience with a new method for percutaneous renal biopsy. Nephrol Dial Transplant 1991;6:731–733.
Carrington CP, Williams A, Griffiths DF, Riley SG, Donovan KL: Adult day-case renal biopsy: a single-centre experience. Nephrol Dial Transplant 2011;26:1559–1563.
Whittier WL, Korbet SM: Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol 2004;15:142–147.
Nass K, O’Neill WC: Bedside renal biopsy: ultrasound guidance by the nephrologist. Am J Kidney Dis 1999;34:955–959.
Ori Y, Neuman H, Chagnac A, et al: Using the automated biopsy gun with real-time ultrasound for native renal biopsy. Isr Med Assoc J 2002;4:698–701.
Riehl J, Maigatter S, Kierdorf H, Schmitt H, Maurin N, Sieberth HG: Percutaneous renal biopsy: comparison of manual and automated puncture techniques with native and transplanted kidneys. Nephrol Dial Transplant 1994;9:1568–1574.
Atwell TD, Smith RL, Hesley GK, et al: Incidence of bleeding after 15,181 percutaneous biopsies and the role of aspirin. AJR Am J Roentgenol 2010;194:784–789.
Lankester M, Ducros J, Labastie J, Lacombe P, Pascal S, Saingra S: Ponction biopsie rénale échoguidée. JEMU 1987;6:275–278.
Scheckner B, Peyser A, Rube J, et al: Diagnostic yield of renal biopsies: a retrospective single center review. BMC Nephrol 2009;10:11.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.