Optimization of Pediatric Kidney Biopsy: Impact of Needle Size and Passes
Academic Radiology, cilt.32, sa.6, ss.3659-3666, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 6
- Basım Tarihi: 2025
- Doi Numarası: 10.1016/j.acra.2025.04.019
- Dergi Adı: Academic Radiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Sayfa Sayıları: ss.3659-3666
- Anahtar Kelimeler: Complications, Glomerular yield, Needle size, Needle passes, Pediatric kidney biopsy, Ultrasound-guided biopsy.
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Purpose: This study evaluated the impact of needle size and the number of passes on complication rates and glomerular yield in pediatric native kidney biopsies performed under real-time ultrasound (US) guidance, aiming to determine the optimal biopsy approach. Materials and Methods: Pediatric native kidney biopsies performed between March 2019 and February 2022 at a single tertiary-care children's hospital were included. Biopsies were done with a semi-automated 16 G needle until December 2020, then with an 18 G needle, with varying numbers of passes. US examinations were conducted 24 h post-biopsy to assess complications. Patients were categorized into six subgroups using needle size and the number of passes and compared for complication rates, glomerular yield, and diagnostic adequacy. Results: A total of 145 pediatric patients (59.3% female, 40.7% male) with a mean age of 10.74 (±4.69) years were included. An 18 G needle was used in 76 (52.4%) cases and a 16 G needle in 69 (47.6%) cases. Minor complications occurred in 56 (38.6%) cases, with no major complications. Complication rates were not significantly different between 18 G and 16 G (p=0.088) but increased with the number of passes (p<0.001). Mean glomerular yield was higher with 16 G than 18 G (34.6 vs. 22.6, p<0.001), though not significantly affected by the number passes (p=0.123). The 18 G needle was associated with inadequate sampling (p=0.024). The optimal scenario was a 16 G needle with one or two passes. Conclusion: Real-time US-guided pediatric kidney biopsy is safe. A 16 G needle with one or two passes optimizes glomerular yield without increasing complications. Three or more passes should be avoided.