How to Perform Kidney Biopsy under Ultrasound Guidance

Renal biopsy is an invaluable diagnostic method in nephrology subspecialty field. It has diagnostic and prognostic values. As a diagnostic method it was done a century ago by indirect visualization of kidney. The method of kidney tissue sampling has been developing in two ways: 1.From blind sampling to more developing type which has been taken under real-time direct visualizing by ultrasound guidance 2. Use of manual to Co-Axial automatic biopsy needles(guns). To minimized major complications such as hemorrhage and hematoma, a history, physical examination, appropriate laboratory tests should be performed and make a point for exact needle insertion and any kidneys abnormalities by pre-biopsy kidneys ultrasound. As a general rule patient should be fix in prone position and put an appropriate towel under biopsy side. Then marked area should prep and drape, use local anesthesia. There are two maneuvers for kidney biopsy of lower pole of kidneys (Usually left kidney): Short-Axis (Out-of-Plane) versus Long-Axis (In-Plane) visualization. If available the coaxial needle can be easily positioned at the site of kidney biopsy for extracting more tissue with less damage. This brief lecture will illustrate Short-Axis (Out-of-Plane) versus Long-Axis (In-Plane) visualization and taking samples by Co-axial automatic gun on a special phantom model.