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We can certainly understand your concern about the use of sonography as a tool for localization in performing percutaneous renal biopsies. As a matter of fact, after our first two biopsies, we nearly abandoned the use of sonography because of significant bleeding. Both patients, however, had several minor contraindications to performing a renal biopsy and, prior to the advent of ultrasound, one would not have localized the kidneys. The two patients were uremic and were receiving dialysis; they both had small kidneys and were hypertensive. However, we felt it was absolutely necessary to make a diagnosis. In calendar year 1977, a total of 71 percutaneous renal biopsies were performed with only one instance of minor hematuria postbiopsy.We do utilize the Goldberg transducer on occasion, especially if the patient is obese.We have confidence in the method and feel that at this time, it is superior to image
Mailloux LU. Ultrasonic Guidance for Renal Biopsy-Reply. Arch Intern Med. 1979;139(2):252. doi:10.1001/archinte.1979.03630390102041