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(Radiology. 2000;215:689-693.)
© RSNA, 2000

Vascular and Interventional Radiology

Transjugular versus Percutaneous Renal Biopsy for the Diagnosis of Parenchymal Disease: Comparison of Sampling Effectiveness and Complications1

Philippe Cluzel, MD, Frank Martinez, MD, Marie France Bellin, MD, Yann Michalik, MD, Hélène Beaufils, MD, Chantal Jouanneau, BS, Olivier Lucidarme, MD, Gilbert Deray, MD and Philippe A. Grenier, MD

1 From the Diagnostic and Interventional Polyvalent Radiology Service (P.C., M.F.B., Y.M., O.L., P.A.G.) and the Nephrology Service (F.M., G.D.), Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, 43-87 boulevard de l'Hôpital, 75651 Paris cedex 13, France; Unité Institut National de la Santé et de la Recherche Médicale (INSERM) 423, Paris, France (H.B., C.J.); and Unité INSERM 494, Paris, France (P.A.G.). Received May 7, 1999; revision requested July 16; revision received August 31; accepted September 24. Address correspondence to P.C. (e-mail: philippe .cluzel@psl.ap-hop-paris.fr).

PURPOSE: To compare the effectiveness and safety of transjugular renal biopsy with those of percutaneous renal biopsy for diagnosis of renal parenchymal disease.

MATERIALS AND METHODS: Results and complications of 400 consecutive transjugular renal biopsies performed between 1993 and 1998 with a modified Colapinto transjugular hepatic biopsy system were compared retrospectively with those of 400 percutaneous renal biopsies performed during the same period. Transjugular renal biopsy was associated with 14 cardiac and 35 hepatic biopsies. Number of glomeruli per tissue core, adequacy of tissue core for histopathologic diagnosis, and rate and severity of complications were analyzed.

RESULTS: Renal tissue was obtained with percutaneous renal biopsy in 382 (95.5%) 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 optical microscopy were 11.2 ± 7.7 (SD) and 9.8 ± 7.6 for percutaneous renal biopsy and transjugular renal biopsy, respectively. With immunofluorescent microscopy, the mean numbers were 6.4 ± 5.3 and 4.6 ± 4.6 for percutaneous renal biopsy and transjugular renal biopsy, respectively. Tissue cores were adequate for histopathologic diagnosis in 98.2% with both techniques. Major complications occurred with transjugular renal biopsy in four patients 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 percutaneous renal biopsy contraindication or failure.

Index terms: Biopsies, complications, 81.458 • Biopsies, technology, 81.1261 • Kidney, biopsy, 81.1261, 81.458




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