title: Real-time ultrasound-guided percutaneous renal biopsy with needle guide by nephrologists decreases post-biopsy complications.
abstract: BACKGROUND
  Percutaneous renal biopsy (PRB) can result in serious complications. The study is aimed to compare the biopsy yield and complications rate of the real-time ultrasonagram (USG)-guided PRB and needle tracking with and without needle guide in two different study periods.
  
  
  METHODS
  We compared the yield and complications of 2138 kidney biopsies performed in two different periods, 1510 biopsies during the first period from April 2004-December 2010 and 628 biopsies during second period from January 2011-March 2013. All biopsies in both periods were performed by nephrologists. Radiologists provided the real-time image without needle guide during the first period while nephrologists performed both imaging and biopsy with needle guide during the second period.
  
  
  RESULTS
  Of all the 2138 patients, 226 (10.5%) patients developed 118 minor and 108 major complications. Only 13 (2.1%) major complications occurred in the second period and 95 (6.7%) in the first period (P < 0.001). The relative risk of developing a major complication without guide was 3.04 times greater than that of the biopsies performed with use of the guide. The mean number of glomeruli per biopsy obtained during the second period (17.98 ± 6.75) was significantly greater than that of the first period (14.14 ± 6.01) (P = 0.004). The number of passes to acquire adequate tissue (P = 0.001) and percentage of cortex on biopsy (P = 0.001) were also significantly better in the second period. The optimal observation period post biopsy is 24 h.
  
  
  CONCLUSIONS
  Real-time USG imaging supported by needle guide device is associated with better biopsy yield and fewer complications.
authors: Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Narayan
authors: N
authors: Prasad
authors: Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Shashi
authors: S
authors: Kumar
authors: Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Revanasiddappa
authors: R
authors: Manjunath
authors: Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Dharmendra
authors: D
authors: Bhadauria
authors: Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Anupama
authors: A
authors: Kaul
authors: Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Raj K
authors: RK
authors: Sharma
authors: Department of Nephrology and Renal Transplantation , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Amit
authors: A
authors: Gupta
authors: Department of Radiology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Hira
authors: H
authors: Lal
authors: Department of Pathology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Manoj
authors: M
authors: Jain
authors: Department of Pathology , Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India.
authors: Vinita
authors: V
authors: Agrawal
keywords: Ultra-pro needle guide; complications; percutaneous renal biopsy; real-time ultrasound