Clinical complications in renal biopsy using two different needle gauges: The impact of large hematomas, a random clinical trial study

• Published in: International journal of urology Vol. 25; no. 6; pp. 544 - 548
• Main Authors: Antunes, Paulo Ramos Botelho, Prado, Fabiano Franco Monteiro, Souza, Fabrício Tinôco Alvim, Siqueira, Elisa Carvalho, Campos, Marcos Álvares, Álvares, Maria Carolina Barbosa, Neto, Rene Berindoague
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.06.2018
• Subjects: Adolescent; Adult; Aged; Biopsy; Biopsy, Needle - adverse effects; Biopsy, Needle - instrumentation; Biopsy, Needle - methods; clinical complications; Clinical trials; Female; Gauges; Hematoma; Hematoma - epidemiology; Hematoma - etiology; Humans; Image-Guided Biopsy - adverse effects; Image-Guided Biopsy - instrumentation; Image-Guided Biopsy - methods; Kidney - diagnostic imaging; Kidney - pathology; Kidneys; Male; Middle Aged; needle gauges; Needles - adverse effects; Postoperative Complications - epidemiology; Postoperative Complications - etiology; renal biopsy; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - pathology; Treatment Outcome; Ultrasonic imaging; Ultrasonography; Ultrasonography, Interventional; Ultrasound; Young Adult; needle gauges; clinical complications; ultrasonography; hematoma; renal biopsy
• ISSN: 0919-8172; 1442-2042
• DOI: 10.1111/iju.13559

Objective To compare complications of ultrasound‐guided percutaneous renal biopsy using two needle gauges (16‐G and 18‐G). Methods A total of 238 individuals with renal biopsy indication were included and randomly separated into two groups: ultrasound‐guided percutaneous renal biopsy procedure carried out with a 16‐G or 18‐G needle. The adequacy of biopsy samples and post‐procedure complications were compared between the two groups. Results The procedures carried out with a 16‐G needle collected fragments with a mean of 22.1 ± 10.8 glomeruli, and those carried out with an 18‐G needle had a mean of 17.5 ± 9.4 glomeruli. Patients submitted to renal biopsies with a 16‐G needle had a higher likelihood of having a complication (OR5.1, 95% CI 1.7–15.4, P = 0.001). The overall mean volume of post‐biopsy hematoma in patients with complications was significantly larger than those without complications (44 ± 56.1 mL vs 5.9 ± 6.6 mL; P < 0.001). Conclusions Renal biopsies carried out by ultrasonography using an 18‐G needle provide adequate histological analysis, showing a lower amount of glomeruli but with similar clinical quality as a 16‐G needle. Furthermore, it is associated with a lower risk of procedure‐related complications.