Ultrasound-guided percutaneous renal biopsy: Free-hand versus puncture attachment

Objective Ultrasound-guided percutaneous renal biopsy is a common diagnostic tool for renal disease. This study investigated the safety and efficiency of free-hand and puncture attachment approaches for ultrasound-guided percutaneous renal biopsy. Methods This retrospective, single-center study included 110 patients who underwent ultrasound-guided percutaneous renal biopsy. The patients were divided into the free-hand or puncture attachment group, depending on whether a puncture attachment was used. Results The number of glomeruli obtained in the free-hand group was similar to that in the puncture attachment group. Two patients had no glomeruli visible under the microscope and could not be diagnosed. The most common etiologies were immunoglobulin A nephropathy (42 patients; 38.2%) and hypertensive nephropathy (27 patients; 24.5%). Most participants received individual antihemorrhagic treatments. Only three patients had postoperative complications, including gross hematuria, perinephric hematoma, and transient fever, with no significant difference between the free-hand and puncture attachment groups. After biopsy, the number of urinary red blood cells rapidly increased during the first micturition and then decreased during the third micturition. Conclusions The rates of hematuria and glomerular yield after renal biopsy were similar between the free-hand and puncture attachment groups. The free-hand approach could be a safe and efficient technique for patients undergoing ultrasound-guided percutaneous renal biopsy without puncture attachment.