Skip to main content
SpringerLink
Log in

Percutaneous and Transjugular Kidney Biopsy

  • Chapter
  • First Online:
Percutaneous Image-Guided Biopsy

  • 1700 Accesses

Abstract

Percutaneous renal biopsy in selected patients can help establish an exact histological diagnosis of kidney disease and can help determine appropriate therapy. The most common complication of percutaneous renal biopsy is bleeding; however, in most patients, bleeding is slight and is of no clinical consequence. Severe bleeding is encountered in only 6 % of cases. Transjugular renal biopsy has been suggested as an alternative to percutaneous renal biopsy to decrease the risk of hemorrhage in high-risk patients. In appropriately selected patients, renal biopsy may affect patient care in up to 60 % of cases.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Richards NT, Darby S, Howie AJ, Adu D, Michael J. Knowledge of renal histology alters patient management in over 40% of cases. Nephrol Dial Transplant. 1994;9:1255–9.

    PubMed  CAS  Google Scholar 

  2. Pfister M, Jakob S, Frey FJ, Niederer U, Schmidt M, Marti HP. Judgment analysis in clinical nephrology. Am J Kidney Dis. 1999;34:569–75.

    Article  PubMed  CAS  Google Scholar 

  3. Cohen AH, Nast CC, Adler SG, Kopple JD. Clinical utility of kidney biopsies in the diagnosis and management of renal disease. Am J Nephrol. 1989;9:309–15.

    Article  PubMed  CAS  Google Scholar 

  4. McGregor DO, Lynn KL, Bailey RR, Robson RA, Gardner J. Clinical audit of the use of renal biopsy in the management of isolated microscopic hematuria. Clin Nephrol. 1998;49:345–8.

    PubMed  CAS  Google Scholar 

  5. Fuiano G, Mazza G, Comi N, et al. Current indications for renal biopsy: a questionnaire-based survey. Am J Kidney Dis. 2000;35:448–57.

    Article  PubMed  CAS  Google Scholar 

  6. Seshan SV, Jennette JC. Renal disease in systemic lupus erythematosus with emphasis on classification of lupus glomerulonephritis: advances and implications. Arch Pathol Lab Med. 2009;133:233–48.

    PubMed  Google Scholar 

  7. Joseph AJ, Compton SP, Holmes LH, et al. Utility of percutaneous renal biopsy in chronic kidney disease. Nephrology (Carlton). 2010;15:544–8.

    Article  Google Scholar 

  8. Curtis JJ, Rakowski TA, Argy Jr WP, Schreiner GE. Evaluation of percutaneous kidney biopsy in advanced renal failure. Nephron. 1976;17:259–69.

    Article  PubMed  CAS  Google Scholar 

  9. Kropp KA, Shapiro RS, Jhunjhunwala JS. Role of renal biopsy in end stage renal failure. Urology. 1978;12:631–4.

    Article  PubMed  CAS  Google Scholar 

  10. Sobh M, Moustafa F, Ghoniem M. Value of renal biopsy in chronic renal failure. Int Urol Nephrol. 1988;20:77–83.

    Article  PubMed  CAS  Google Scholar 

  11. Turner MW, Hutchinson TA, Barre PE, Prichard S, Jothy S. A prospective study on the impact of the renal biopsy in clinical management. Clin Nephrol. 1986;26:217–21.

    PubMed  CAS  Google Scholar 

  12. Furness PN, Philpott CM, Chorbadjian MT, et al. Protocol biopsy of the stable renal transplant: a multicenter study of methods and complication rates. Transplantation. 2003;76:969–73.

    Article  PubMed  Google Scholar 

  13. Rush D, Nickerson P, Gough J, et al. Beneficial effects of treatment of early subclinical rejection: a randomized study. J Am Soc Nephrol. 1998;9:2129–34.

    PubMed  CAS  Google Scholar 

  14. Seron D, Moreso F, Ramon JM, et al. Protocol renal allograft biopsies and the design of clinical trials aimed to prevent or treat chronic allograft nephropathy. Transplantation. 2000;69:1849–55.

    Article  PubMed  CAS  Google Scholar 

  15. Moreso F, Lopez M, Vallejos A, et al. Serial protocol biopsies to quantify the progression of chronic transplant nephropathy in stable renal allografts. Am J Transplant. 2001;1:82–8.

    Article  PubMed  CAS  Google Scholar 

  16. Health and Public Policy Committee, American College of Physicians. Clinical competence in percutaneous renal biopsy. Ann Intern Med. 1988;108:301–3.

    Article  Google Scholar 

  17. Madaio MP. Renal biopsy. Kidney Int. 1990;38:529–43.

    Article  PubMed  CAS  Google Scholar 

  18. Mendelssohn DC, Cole EH. Outcomes of percutaneous kidney biopsy, including those of solitary native kidneys. Am J Kidney Dis. 1995;26:580–5.

    Article  PubMed  CAS  Google Scholar 

  19. Haas M, Spargo BH, Wit EJ, Meehan SM. Etiologies and outcome of acute renal insufficiency in older adults: a renal biopsy study of 259 cases. Am J Kidney Dis. 2000;35:433–47.

    Article  PubMed  CAS  Google Scholar 

  20. Kohli HS, Jairam A, Bhat A, et al. Safety of kidney biopsy in elderly: a prospective study. Int Urol Nephrol. 2006;38:815–20.

    Article  PubMed  Google Scholar 

  21. Uezono S, Hara S, Sato Y, et al. Renal biopsy in elderly patients: a clinicopathological analysis. Ren Fail. 2006;28:549–55.

    Article  PubMed  Google Scholar 

  22. Moutzouris DA, Herlitz L, Appel GB, et al. Renal biopsy in the very elderly. Clin J Am Soc Nephrol. 2009;4:1073–82.

    Article  PubMed  CAS  Google Scholar 

  23. Packham D, Fairley KF. Renal biopsy: indications and complications in pregnancy. Br J Obstet Gynaecol. 1987;94:935–9.

    Article  PubMed  CAS  Google Scholar 

  24. Chen HH, Lin HC, Yeh JC, Chen CP. Renal biopsy in pregnancies complicated by undetermined renal disease. Acta Obstet Gynecol Scand. 2001;80:888–93.

    Article  PubMed  CAS  Google Scholar 

  25. Kuller JA, D'Andrea NM, McMahon MJ. Renal biopsy and pregnancy. Am J Obstet Gynecol. 2001;184:1093–6.

    Article  PubMed  CAS  Google Scholar 

  26. Lindheimer MD, Davison JM. Renal biopsy during pregnancy: ‘to b… or not to b…?’. Br J Obstet Gynaecol. 1987;94:932–4.

    Article  PubMed  CAS  Google Scholar 

  27. Day C, Hewins P, Hildebrand S, et al. The role of renal biopsy in women with kidney disease identified in pregnancy. Nephrol Dial Transplant. 2008;23:201–6.

    Article  PubMed  Google Scholar 

  28. Korbet SM. Percutaneous renal biopsy. Semin Nephrol. 2002;22:254–67.

    Article  PubMed  Google Scholar 

  29. Wiseman DA, Hawkins R, Numerow LM, Taub KJ. Percutaneous renal biopsy utilizing real time, ultrasonic guidance and a semiautomated biopsy device. Kidney Int. 1990;38:347–9.

    Article  PubMed  CAS  Google Scholar 

  30. Maya ID, Maddela P, Barker J, Allon M. Percutaneous renal biopsy: comparison of blind and real-time ultrasound-guided technique. Semin Dial. 2007;20:355–8.

    Article  PubMed  Google Scholar 

  31. Doyle AJ, Gregory MC, Terreros DA. Percutaneous native renal biopsy: comparison of a 1.2-mm spring-driven system with a traditional 2-mm hand-driven system. Am J Kidney Dis. 1994;23:498–503.

    PubMed  CAS  Google Scholar 

  32. Kim D, Kim H, Shin G, et al. A randomized, prospective, comparative study of manual and automated renal biopsies. Am J Kidney Dis. 1998;32:426–31.

    Article  PubMed  CAS  Google Scholar 

  33. Burstein DM, Korbet SM, Schwartz MM. The use of the automatic core biopsy system in percutaneous renal biopsies: a comparative study. Am J Kidney Dis. 1993;22:545–52.

    PubMed  CAS  Google Scholar 

  34. Feneberg R, Schaefer F, Zieger B, Waldherr R, Mehls O, Scharer K. Percutaneous renal biopsy in children: a 27-year experience. Nephron. 1998;79:438–46.

    Article  PubMed  CAS  Google Scholar 

  35. 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;9:1568–74.

    PubMed  CAS  Google Scholar 

  36. Nyman RS, Cappelen-Smith J, al Suhaibani H, Alfurayh O, Shakweer W, Akhtar M. Yield and complications in percutaneous renal biopsy. A comparison between ultrasound-guided gun-biopsy and manual techniques in native and transplant kidneys. Acta Radiol. 1997;38:431–6.

    PubMed  CAS  Google Scholar 

  37. Appel GB. Renal biopsy: how effective, what technique, and how safe. J Nephrol. 1993;6:4.

    Google Scholar 

  38. Cluzel P, Martinez F, Bellin MF, et al. Transjugular versus percutaneous renal biopsy for the diagnosis of parenchymal disease: comparison of sampling effectiveness and complications. Radiology. 2000;215:689–93.

    PubMed  CAS  Google Scholar 

  39. Misra S, Gyamlani G, Swaminathan S, et al. Safety and diagnostic yield of transjugular renal biopsy. J Vasc Interv Radiol. 2008;19:546–51.

    Article  PubMed  Google Scholar 

  40. Stiles KP, Yuan CM, Chung EM, Lyon RD, Lane JD, Abbott KC. Renal biopsy in high-risk patients with medical diseases of the kidney. Am J Kidney Dis. 2000;36:419–33.

    Article  PubMed  CAS  Google Scholar 

  41. See TC, Thompson BC, Howie AJ, et al. Transjugular renal biopsy: our experience and technical considerations. Cardiovasc Intervent Radiol. 2008;31:906–18.

    Article  PubMed  Google Scholar 

  42. Stratta P, Canavese C, Marengo M, et al. Risk management of renal biopsy: 1387 cases over 30 years in a single centre. Eur J Clin Invest. 2007;37:954–63.

    Article  PubMed  CAS  Google Scholar 

  43. Shidham GB, Siddiqi N, Beres JA, et al. Clinical risk factors associated with bleeding after native kidney biopsy. Nephrology (Carlton). 2005;10:305–10.

    Article  Google Scholar 

  44. Parrish AE. Complications of percutaneous renal biopsy: a review of 37 years’ experience. Clin Nephrol. 1992;38:135–41.

    PubMed  CAS  Google Scholar 

  45. Harrison KL, Nghiem HV, Coldwell DM, Davis CL. Renal dysfunction due to an arteriovenous fistula in a transplant recipient. J Am Soc Nephrol. 1994;5:1300–6.

    PubMed  CAS  Google Scholar 

  46. Patel MD, Phillips CJ, Young SW, et al. US-guided renal transplant biopsy: efficacy of a cortical tangential approach. Radiology. 2010;256:290–6.

    Article  PubMed  Google Scholar 

  47. McCune TR, Stone WJ, Breyer JA. Page kidney: case report and review of the literature. Am J Kidney Dis. 1991;18:593–9.

    PubMed  CAS  Google Scholar 

  48. Bakri RS, Prime M, Haydar A, Glass J, Goldsmith DJ. Three ‘Pages’ in a chapter of accidents. Nephrol Dial Transplant. 2003;18:1917–19.

    Article  PubMed  Google Scholar 

  49. Whittier WL, Korbet SM. Timing of complications in percutaneous renal biopsy. J Am Soc Nephrol. 2004;15:142–7.

    Article  PubMed  Google Scholar 

  50. Nass K, O'Neill WC. Bedside renal biopsy: ultrasound guidance by the nephrologist. Am J Kidney Dis. 1999;34:955–9.

    Article  PubMed  CAS  Google Scholar 

  51. Eiro M, Katoh T, Watanabe T. Risk factors for bleeding complications in percutaneous renal biopsy. Clin Exp Nephrol. 2005;9:40–5.

    Article  PubMed  Google Scholar 

  52. Schow DA, Vinson RK, Morrisseau PM. Percutaneous renal biopsy of the solitary kidney: a contraindication? J Urol. 1992;147:1235–7.

    PubMed  CAS  Google Scholar 

  53. Yuan CM, Jindal RM, Abbott KC. Biopsy: observation time after kidney biopsy: when to discharge? Nat Rev Nephrol. 2009;5:552–4.

    Article  PubMed  Google Scholar 

  54. Maya ID, Allon M. Percutaneous renal biopsy: outpatient observation without hospitalization is safe. Semin Dial. 2009;22(4):458–61.

    Article  PubMed  Google Scholar 

  55. Al-Hweish AK, Abdul-Rehaman IS. Outpatient percutaneous renal biopsy in adult patients. Saudi J Kidney Dis Transpl. 2007;18:541–6.

    PubMed  Google Scholar 

  56. Toledo K, Perez MJ, Espinosa M, et al. Complications associated with percutaneous renal biopsy in Spain, 50 years later. Nefrologia. 2010;30:539–43.

    PubMed  CAS  Google Scholar 

  57. Jain V, Ganpule A, Vyas J, et al. Management of non-neoplastic renal hemorrhage by transarterial embolization. Urology. 2009;74:522–6.

    Article  PubMed  Google Scholar 

  58. Haas M. A reevaluation of routine electron microscopy in the examination of native renal biopsies. J Am Soc Nephrol. 1997;|8:70–6.

    PubMed  CAS  Google Scholar 

  59. Oberholzer M, Torhorst J, Perret E, Mihatsch MJ. Minimum sample size of kidney biopsies for semiquantitative and quantitative evaluation. Nephron. 1983;34:192–5.

    Article  PubMed  CAS  Google Scholar 

  60. Bolton WK. Nonhemorrhagic decrements in hematocrit values after percutaneous renal biopsy. JAMA. 1977;238:1266–8.

    Article  PubMed  CAS  Google Scholar 

  61. Molne J, Breimer ME, Svalander CT. Immunoperoxidase versus immunofluorescence in the assessment of human renal biopsies. Am J Kidney Dis. 2005;45:674–83.

    Article  PubMed  Google Scholar 

  62. 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;58:390–5.

    Article  PubMed  CAS  Google Scholar 

  63. Pasquariello A, Innocenti M, Batini V, et al. Theoretical calculation of optimal depth in the percutaneous native kidney biopsy to drastically reduce bleeding complications and sample inadequacy for histopathological diagnosis. Nephrol Dial Transplant. 2007;22:3516–20.

    Article  PubMed  Google Scholar 

  64. Abbott KC, Yuan CM, Batty DS, Lane JD, Stiles KP. Transjugular biopsy in patients with combined renal and liver disease: making every organ count. Am J Kidney Dis. 2001;37:1304–7.

    Article  PubMed  CAS  Google Scholar 

  65. Jouet P, Meyrier A, Mal F, et al. Transjugular renal biopsy in the treatment of patients with cirrhosis and renal abnormalities. Hepatology. 1996;24:1143–7.

    Article  PubMed  CAS  Google Scholar 

  66. Mal F, Meyrier A, Callard P, Kleinknecht D, Altmann JJ, Beaugrand M. The diagnostic yield of transjugular renal biopsy. Experience in 200 cases. Kidney Int. 1992;41:445–9.

    Article  PubMed  CAS  Google Scholar 

  67. Sam R, Leehey DJ, Picken MM, et al. Transjugular renal biopsy in patients with liver disease. Am J Kidney Dis. 2001;37:1144–51.

    Article  PubMed  CAS  Google Scholar 

  68. Thompson BC, Kingdon E, Johnston M, et al. Transjugular kidney biopsy. Am J Kidney Dis. 2004;43:651–62.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Interventional Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 1471, Houston, TX, 77030, USA

    Judy U. Ahrar MD

  2. Department of Radiology, Baylor College of Medicine, One Baylor Plaza, Unit 360, Houston, TX, 77030, USA

    Sanaz Javadi MD

  3. Department of Interventional Radiology, Department of Thoracic and Cardiovascular Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1471, Houston, TX, 77030, USA

    Kamran Ahrar MD, FSIR

Authors
  1. Judy U. Ahrar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sanaz Javadi MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kamran Ahrar MD, FSIR
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kamran Ahrar MD, FSIR .

Editor information

Editors and Affiliations

  1. Dept. Vascular & Interventional Radiol., University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Kamran Ahrar

  2. Department of Diagnostic Radiology Section of Interventional Radiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA

    Sanjay Gupta

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Ahrar, J.U., Javadi, S., Ahrar, K. (2014). Percutaneous and Transjugular Kidney Biopsy. In: Ahrar, K., Gupta, S. (eds) Percutaneous Image-Guided Biopsy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8217-8_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8217-8_18

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8216-1

  • Online ISBN: 978-1-4614-8217-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation