Abstract
Introduction: Renal biopsies in India were usually done by nephrologists with the help of radiologists. Accommodating a procedure like renal biopsy into the radiologists’ busy schedule is often a difficult task. To overcome this, nephrologists nowadays have trained themselves to do ultrasound guided renal biopsies without radiologist s guidance.
Objectives: Primary objective of the current study was to look for adequacy of the specimen for histopathologic examination and secondary objective was to analyse procedure related complications.
Patients and Methods: With this retrospective study we share our biopsy experience between January 2013 to May 2014.There was no comparative arm in our series as we have been doing biopsies without radiologist guidance since 2006. All patients underwent a set list of investigations prior to biopsy. After obtaining written consent, both USG and renal biopsy were done by the nephrologist using an automatic spring loaded biopsy gun with 18G disposable needle.
Results: Fifty percent of patients in this series were in the 20-50 years age group. The most common clinical presentation requiring renal biopsy in our series was nephrotic syndrome (100/254) followed by unexplained worsening of renal function (77/254). The procedure was very safe with only two patients out of 254 requiring blood transfusion. Minor complication like mild hematuria not requiring blood transfusion was seen in 18/254 patients and small perinephric hematoma in 16/254 patients. In 236 patients two cores of tissue were obtained and this was achieved with two needle pass in 150/236(59.1%) biopsies. More than three attempts were not required in any of them. Mean number of glomeruli was 11.69 and a histological diagnosis was possible in all cases.
Conclusion: Our series shows that renal biopsies can be safely done by nephrologist alone with good yield.