The clinical efficacy of transjugular renal biopsy.
ASN 30th Annual Meeting, San Antonio
J Am Soc Nephrol (Sep) 8:145A 1997
Transjugular renal biopsy has been performed in patients who are poor candidates for percutaneous biopsy due to conditions such as bleeding diatheses, severe COPD, and morbid obesity. Six patients with nephrotic syndrome requiring chronic anticoagulation underwent the procedure. The procedure involved insertion of an 80 cm long multipurpose catheter into the right renal vein via the right internal jugular vein. A 62 cm straight catheter and 60 cm side-cut Quickcore biopsy needle were next introduced in order to sample cortical tissue. Capsular perforation was treated with Gelfoam. A total of 7 procedures were performed in the 6 patients. A mean of 4.14 (range 2-8) passes were made to obtain 3.3 (2-5) cores per procedure. A histologic diagnosis was made in all 6 patients (one required re- biopsy). A mean of 5.8 (2-10) glomeruli were obtained. Clinically insignificant perirenal hematoma occurred in 6/7 procedures and gross hematuria complicated 3/7. The authors conclude that this technique can be safely used in patients at high risk for percutaneous biopsy.
Comment: This is a small series and the results are not particularly impressive. Although there is undoubtedly a learning curve with this as with any procedure, it is doubtful that this technique will replace percutaneous procedure at any time in the near future. (David J. Leehey, M.D., Loyola University at Chicago)
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ASN 30th Annual Meeting, San Antonio
Proteinuria/Hematuria : Renal biopsy techniques, tips, complications