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Alain Meyrier, Transjugular renal biopsy. Update on hepato-renal needlework, Nephrology Dialysis Transplantation, Volume 20, Issue 7, July 2005, Pages 1299–1302, https://doi.org/10.1093/ndt/gfh866
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Extract
Introduction
In 1990, a poster presented at the American Society of Nephrology kindled curiosity [1]. The placard indicated that renal biopsy can be performed by puncturing the right kidney from inside, with a needle inserted along a catheter running from the jugular vein into the lower pole. Publications followed, from those who had broken new ground and thereafter from many members of the nephrological circles. Most confirmed the interest in the jugular route, others brought grist to the mill, yet others were definitely misleading regarding the technique, its indications and its complications. It is therefore time to review the issue of transjugular renal biopsy (TJRB) in the light of acquired experience and to formulate recommendations and caveats.
From liver to kidney: going astray to the right vein
Transjugular liver biopsy was described in 1964 [2]. Its rationale is simple: the hepatic veins open into the vena cava almost vertically. It is easy to introduce a catheter through the right jugular vein down to the hepatic veins and let it guide a long rigid needle to obtain a sample of liver tissue, under aspiration, according to the Menghini technique. As liver disease entails a risk of bleeding, and its capsule is far from the needle tip, the liver will bleed back into the circulation.
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