Application of Tru-cut biopsy needle in renal puncture

Objective To perform percutaneous renal puncture biopsy with Tru-cut biopsy needle under the guidance of B ultrasound. Methods a total of 342 patients, including 9 patients with renal insufficiency, were selected for percutaneous renal biopsy with TRU-cut biopsy needle guided by B-ultrasound, compared with 124 patients with Menghini puncture needle with negative pressure aspiration. Results (1) The number of glomerulus removed by TRU-cut biopsy needle was 96.2% (> 10 glomerulus), and the success rate was high. (2) Bleeding was the main complication, the incidence of gross hematuria was 5.6%, the incidence of perirenal hematoma was 2.6%, and there was 1 case (0.3%) of severe bleeding after transfusion of more than 1 000 mL. (3) There were 1 cases of severe bleeding with CKD3 stage, serum creatinine 190-350 μmol/L, urinary protein 3+, bilateral renal diameter 9.2-9.6 cm, cortical thickness normal echo enhancement, pathological diagnosis: sclerositic nephritis. However, there were 5 patients with bilateral kidney length of 9.5~13.4 cm, serum creatinine of 700~1 200μmol/L, pathologic findings: sclerotic nephritis, fibrous crescentulonephritis,Goodpasture's syndrome, hemorrhagic fever renal damage, and myeloma nephropathy. Patients with TRU-cut biopsy needle presented only microscopic hematuria. Conclusion Compared with negative pressure suction, Tru-cut biopsy needle is simple and easy to learn, with high quality samples and similar complications. Renal insufficiency is not contraindicated by puncture. Caution should be taken in patients with small kidneys.

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