Abstract
BackgroundPercutaneous renal biopsy (PRB) is the primary biopsy technique and it was used by 16G needles or 18G needles in China, but there is controversy about the effect and safety of the two different diameters. The study aims to compare the adequacy, complication rate and pathological classification when using 18G vs. 16G needles to perform renal biopsy with ultrasound-guidedance on native kidneys in Chinese individuals.MethodsWe retrospectively analyzed the number of glomeruli, adequate sample rates, complication rates and pathological classification in 270 patients with the use of 18G or 16G needles from January 2011 to May 2017 and verified whether the needle gauge affected the disease diagnosis.ResultsA total of 270 kidney biopsies were performed. Among them,72 were performed with 18G needles, and 198 were performed with 16G needles. There was no difference in the number of glomeruli under light microscope using 18G relative to 16G needles (24 ± 11 vs. 25 ± 11, p = 0.265), whereas more glomeruli were found in the 16G group than in the 16G group using immunofluorescence microscopy (3 ± 2 vs. 5 ± 3, p < 0.05). There was no significant difference in the adequate sample rates between the 18G group and the 16G group (90.28% vs. 93.94%, p = 0.298). Minor complications including the incidence of lumbar or abdominal pain (4.17% vs. 7.07%, p = 0.57), gross hematuria (4.17% vs. 3.54%, p = 0.729), and perinephric hematoma without symptoms (4.17% vs. 1.52%, p = 0.195), were not significantly different between the 18G and 16G groups. In the 16G group, 2 cases of serious complications occurred: severe gross hematuria requiring blood transfusion and retroperitoneal hematoma requiring surgery. No serious complications were observed in the 18G group, although there was no significant difference in serious complications rates between the 18G and 16G groups (0% vs. 1.02%, p = 1).ConclusionThere was no significant difference in the number of glomeruli, adequate sample rates, or complication rates when using 18G or 16G needles to perform renal biopsy, and the use of an 18G needle with a smaller diameter did not affect the pathological diagnosis or classification of IgA nephropathy and lupus nephritis.
Highlights
Percutaneous renal biopsy (PRB) is the primary biopsy technique and it was used by 16G needles or 18G needles in China, but there is controversy about the effect and safety of the two different diameters
The number of glomeruli was similar between the 18G group and the 16G group as detected by light microscopy (24 ± 11 vs. 25 ± 11, p = 0.265), whereas fewer glomeruli were detected in the 18G group than in the 16G group according to the immunofluorescence examination (3 ± 2 vs. 5 ± 3, p < 0.05) (Table 2)
Percutaneous renal biopsy is an essential technique for renal medicine, and the safety and success rates of PRB have been further improved after the introduction of automatic biopsy needles and real-time
Summary
Percutaneous renal biopsy (PRB) is the primary biopsy technique and it was used by 16G needles or 18G needles in China, but there is controversy about the effect and safety of the two different diameters. The study aims to compare the adequacy, complication rate and pathological classification when using 18G vs 16G needles to perform renal biopsy with ultrasound-guidedance on native kidneys in Chinese individuals. 16G needles or 18G needles are used for percutaneous renal biopsy in China, but there is still controversy about the effect and safety of 18G and 16G biopsy needles in terms of the two different diameters. We retrospectively studied the number of glomeruli, adequate sample rates, complication rates, disease spectrum and pathological classification in patients who underwent renal biopsy with the use of 18G and 16G needles to compare the differences when using these biopsy needles
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