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Is bigger better? A retrospective analysis of native renal biopsies with 16 G auge versus 18 G auge automatic needles
Author(s) -
Mai Jun,
Yong Jim,
Dixson Hugh,
Makris Angela,
Aravindan Ananthakrishnapuram,
Suranyi Michael G,
Wong Jeffrey
Publication year - 2013
Publication title -
nephrology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.752
H-Index - 61
eISSN - 1440-1797
pISSN - 1320-5358
DOI - 10.1111/nep.12093
Subject(s) - medicine , biopsy , retrospective cohort study , renal biopsy , kidney , complication , significant difference , ultrasound , kidney disease , percutaneous , urology , surgery , radiology
Aim Percutaneous renal biopsy ( PRB ) remains the gold standard for the diagnosis of renal disease; however, the tissue yield which relates to the optimal needle size used for native‐kidney biopsies has not been clearly established. Our study compares the sample adequacy and complication rates using 16 gauge ( G ) and 18 gauge ( G ) automatic needles on native kidney PRB . Methods A retrospective analysis was performed of native‐kidney biopsies at two centres, one exclusively using 16 G and the other exclusively using 18 G needles. All samples were assessed by a single centralized pathology service. We compared patient characteristics, indications, diagnoses, adequacy of tissue samples, and complications. Results A total of 934 native‐kidney biopsies were performed with real time ultrasound guidance: 753 with B ard M ax C ore 16 G × 16 cm needles, and 181 with B ard M agnum 18 G × 20 cm needles. The median (range) of total glomeruli count per biopsy was higher in the 16 G group compared with the 18 G group (19 (0–66) vs 12 (0–35), P < 0.001), despite having fewer cores per biopsy (2 (0–4) vs 3 (1–4), P < 0.001). The 16 G group provided a greater proportion of adequate biopsy samples (94.7% vs 89.4%, P = 0.001). There was no significant difference in the frequency of total complications between the 16 G and 18 G groups (3.7% vs 2.2%, P = 0.49). Conclusion This retrospective study demonstrates 16 G needles provide more glomeruli, more diagnostically adequate renal tissue, with fewer cores without a significant increase in complications compared with 18 G needles. Based on these observations, 16 G needles should be considered as the first line option in native‐kidney PRB .