Transjugular versus percutaneous renal biopsy for the diagnosis of parenchymal disease: Comparison of sampling effectiveness and complications

PURPOSE: To compare the effectiveness and safety of transjugular renal biop sy with those of percutaneous renal biopsy for diagnosis of renal parenchym al disease. MATERIALS AND METHODS: Results and complications of 400 consecutive transju gular renal biopsies performed between 1993 and 1998 with a modified Colapi nto transjugular hepatic biopsy system were compared retrospectively with t hose of 400 percutaneous renal biopsies performed during the same period. T ransjugular renal biopsy was associated with 14 Cardiac and 35 hepatic biop sies. Number of glomeruli per tissue core, adequacy of tissue core for hist opathologic diagnosis, and rate and severity of complications were analyzed . RESULTS: Renal tissue was obtained with percutaneous renal biopsy in 382 (9 5.5%) of 400 patients and with transjugular renal biopsy in 383 (95.8%) of 400 patients. The mean numbers of intact glomeruli per tissue core with opt ical microscopy were 11.2 +/- 7.7 (SD) and 9.8 +/- 7.6 for percutaneous ren al biopsy and transjugular renal biopsy, respectively. With immunofluoresce nt microscopy, the mean numbers were 6.4 +/- 5.3 and 4.6 +/- 4.6 for percut aneous renal biopsy and transjugular renal biopsy, respectively. Tissue cor es were adequate for histopathologic diagnosis in 98.2% with both technique s. Major complications occurred with transjugular renal biopsy in four pati ents and with percutaneous renal biopsy in three patients. CONCLUSION: Use of transjugular renal biopsy provides diagnostic yield and safety similar to those of percutaneous renal biopsy and allows multiorgan biopsy during the same procedure. It can be recommended in patients with pe rcutaneous renal biopsy contraindication or failure.