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Renal biopsy is one of the invasive and essential diagnostic tests that can guide nephrologists on the further diagnosis and management plans in their routine practice. In addition to procedure related complications such as hematoma, the test may not always provide adequate information. In this study, we aim to test the success rate of percutaneous ultrasound-guided renal biopsy in providing clinically valuable information that guide patients management and prognostic plans.
A retrospective single center chart review study conducted to review all percutaneous ultrasound-guided renal biopsies done at Prince Mohammed bin Abdulaziz Hospital, Riyadh, Saudi Arabia, between January 2021 to September 2023.
During the study period, a total of one hundred and twenty-seven percutaneous ultrasound-guided renal biopsies were performed. The diagnosis was confirmed on one hundred twelve of the cases, and the results were non-conclusive and suboptimal on fifteen cases. The mean age of the patients was Thirty-three years. Female patients accounted for approximately 51% of the cases. The most common glomerulonephritis identified was lupus nephritis class III-V (Twenty-one cases), followed by focal segmental glomerulosclerosis (FSGS) (Eighteen cases).
The use of ultrasound-guided percutaneous renal biopsy was successful in clarifying the diagnosis and guiding the treatment in the majority of the cases. To overcome the challenge of limited and non-conclusive biopsy results, a unified pre-requisite pre-procedural renal biopsy request form can be filled by the primary physician which includes relative information such as clinical history, suspected pre-procedural diagnosis, indication for biopsy, Estimated Glomerular Filtration Rate (eGFR), the presence of hematuria and proteinuria, that can guide clinical histopathologists in reaching a conclusion on the biopsy result. Moreover, transjugular renal biopsy (TRB) can be introduced as an alternative when percutaneous ultrasound-guided renal biopsy is non-conclusive or contraindicated. Further studies can be done to compare the results to other centers, include longer study period, and to test the diagnostic yield, safety and complication rates of percutaneous in comparison to transjugular renal biopsy.