COMPARISON OF AUTOMATED PERCUTANEOUS KIDNEY BIOPSY USING NEEDLES OF DIFFERENT GAUGE

Percutaneous renal biopsy, an essential procedure for the evaluation o f a patient with renal disease, has been improved by the use of semi-a utomated, spring-loaded renal biopsy guns. We have carried out a prosp ective, randomized study comparing the safety and tissue adequacy for histopathological diagnosis of renal biopsies performed under real-tim e ultrasound guidance using the Biopty(R) gun (Bard, Covington, GA, US A) and a 14 or 18 gauge needle on 103 native and 30 transplant kidneys . Repeat biopsy was necessary for only one renal transplant (0.75%) be cause of inadequate tissue. The biopsy procedure was well tolerated an d complications (<5%) were uncommon in both groups. Biopsies of native kidneys with the 14 gauge needle required fewer attempts (3.23 vs 3.9 8; P=0.005) and the cores obtained contained more glomeruli for light (24.8 in 2.78 cores vs 16.0 in 3.03 cores; P=0.0001) and immunofluores cence microscopy (9.5 vs 7.4; P=0.01) than with the 18 gauge needle. S imilarly, more glomeruli were obtained from transplant kidneys with th e 14 gauge needle (19.5 in 1.19 cores vs 12.9 in 1.57 cores; P=0.004). Renal biopsy using the Biopty(R) gun and a 14 gauge needle is safe an d provides adequate tissue for histopathological assessment.