CT guided renal biopsy : Safety and Efficacy, A study in Pakistan.

Abstract

BACKGROUND: Percutaneous renal biopsy (PRB) of native kidney with automated spring loaded device is performed with various techniques to improve efficacy and safety .This study was performed to evaluate (1)the safety and efficacy of  PRB performed under CT guidance  (2) time to develop complications to see whether this procedure can be performed as outpatient, (3) diagnostic yield of the specimen.

Materials and Methods: The study was conducted at the Department of Nephrology of Dr. Ziauddin Hospital, on all patients admitted for renal biopsy between 1^ST January 2009 to 31^st December 2011. PRB was performed on native kidneys by experienced nephrologist under CT guidance with a 18 guage automated spring loaded biopsy gun. Patients were included if they fulfilled the inclusion criteria. All patients were observed for 24 hours post biopsy for major complications like gross hematuria, drop in hemoglobin requiring transfusion, or requiring surgical or radiological intervention and minor complications like transient hematuria, spontaneously resolving perinephric hematoma and their timing of development. In addition, information was gathered regarding diagnostic yield of the specimen.

RESULTS: 100 consecutive biopsies were performed. There were no major complications in 98% of the biopsies. 2% patients developed gross hematuria and significant hematoma with a drop in hemoglobin that required blood transfusion. 2% of patients developed minor complications. 100 % of the specimen had adequate tissue for making the diagnosis. All major complications developed within 12 hours of procedure. The minor complication occurred at 18 hrs.

CONCLUSION: PRB under CT guidance is a safe and effective procedure, however recommendations can not be made to perform it on outpatient basis.  

KEY WORDS: CT , Percutaneous Renal biopsy, safety, complications.