The Use of the Automatic Core Biopsy System in Percutaneous Renal Biopsies: A Comparative Study

We describe our experience with the use of the automatic core biopsy system for percutaneous renal biopsy and compare this with our experience with a standard biopsy needle. Three hundred twenty-three biopsies were performed between June 1983 and January 1993. From June 1983 through October 1990, 232 biopsies were performed with the use of a standard biopsy needle (Tru-cut needle; Travenol Laboratories, Deerfield, IL) and from November 1990 through January 1993, 91 biopsies were conducted with the use of the automatic core biopsy system (Biopty gun and needle; C.R. Bard, Inc, Covington, GA). Biopsies performed prior to January 1990 were reviewed retrospectively, while those performed after January 1990 were reviewed in a prospective manner. The primary indications for renal biopsy were to evaluate proteinuria (48.9%) and renal manifestations of systemic lupus erythematosus (26.0%). The two groups of patients were similar with respect to sex, age, serum creatinine, and coagulation parameters. Material for light microscopy, immunofluorescence microscopy, and electron microscopy was obtained in 98.9%, 98.9%, and 97.8% of cases, respectively, with the use of the automatic core biopsy system, and these values did not differ significantly from those with the use of the standard needle (99.6%, 96.1 %, and 97.8%). Significantly more glomeruli were obtained by light microscopy per biopsy specimen with the use of the automatic core biopsy system versus the standard needle (28 ± 15 and 21 ± 13, respectively; P < 0.0001). Complications were assessed and separated by severity. Total complications were observed in 13 patients (14.3%) with the automatic core device and in 31 patients (13.4%) with the standard needle. Major complications were seen in 7.7% of patients with the automatic core device and in 5.6% of patients with the standard needle. The complication rates between these two groups were found not to be significantly different. We could find no significant difference with respect to age, sex, serum creatinine, systolic or diastolic blood pressure, or coagulation parameters between patients who did or did not develop complications due to the biopsy procedure. The prebiopsy hemoglobin values were similar in patients with and without complications. Despite the presence or absence of complications, both groups had a significant decrease in their hemoglobin values following the procedure (2.7 and 0.9 g/dL, respectively; P < 0.0001), however, the postbiopsy hemoglobi