Adequacy and safety of pediatric native kidney biopsy using 16- and 18-gauge needles.

IF 2.6 3区医学 Q1 PEDIATRICS

Pediatric Nephrology Pub Date : 2025-09-22 DOI:10.1007/s00467-025-06973-1

Petr Ananin, Anastasiia Milovanova, Kirill Kulikov, Ekaterina Stolyarevich, Alexey Tsygin

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引用次数: 0

Abstract

Background: The native kidney biopsy is an important diagnostic procedure in pediatric nephrology. Recent meta-analyses did not find the size of the needle as a risk factor for bleeding complications, but they were predominantly based on adult studies. There are few papers comparing the safety and core adequacy in pediatric native kidney biopsy.

Methods: We present a large single-center retrospective study performed in a tertiary pediatric nephrology center. Data of children who received a real-time ultrasound-guided native kidney biopsy with a 16- or an 18-gauge needle from 2018 to 2024 were analyzed.

Results: Overall, 1040 children (644 boys) were included, with a median age of 10.25 (6.6; 14.23) years. One hundred three (9.9%) patients experienced bleeding complications. Perinephric hematoma was reported in 86 (8.3%) cases, gross hematuria in 18 (1.7%), and 3 (0.3%) children required transfusion. Multivariate regression analysis revealed the needle size (OR for 16-gauge 2.06, 95% CI 1.22-3.47, p = 0.007) as a risk factor for complications in the overall cohort and in children under 12 years old. The needle size did not affect complication rates in children aged 12-18 years. Inadequate kidney cores were reported in 37 (4.5%) cases; OR for 18-gauge needles (OR 5.08, 95% CI 1.07-24.21, p = 0.041) was found.

Conclusions: Use of a 16-gauge needle reduces the risk of obtaining an inadequate core in comparison with an 18-gauge. An 18G needle has a safety advantage over a 16G needle in children younger than 12 years. A 16G needle is as safe as an 18G needle and should be used for native kidney biopsy in children older than 12 years.

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使用16号和18号针头进行小儿原生肾活检的充分性和安全性。

背景：原生肾活检是儿科肾脏病学的重要诊断方法。最近的荟萃分析没有发现针头的大小是出血并发症的危险因素，但它们主要基于成人研究。很少有论文比较儿童原生肾活检的安全性和核心充分性。方法：我们提出了一项大型单中心回顾性研究，在三级儿科肾脏学中心进行。分析了2018年至2024年接受实时超声引导下16号或18号针头天然肾活检的儿童数据。结果：共纳入1040名儿童（644名男孩），中位年龄为10.25（6.6;14.23）岁。103例（9.9%）患者出现出血并发症。肾周血肿86例（8.3%），总血尿18例（1.7%），3例（0.3%）患儿需要输血。多因素回归分析显示针头大小（16号针头OR为2.06,95% CI为1.22-3.47,p = 0.007）是整个队列和12岁以下儿童并发症的危险因素。针的大小对12-18岁儿童的并发症发生率没有影响。37例（4.5%）报告肾芯不足；18号针头的OR （OR 5.08, 95% CI 1.07-24.21, p = 0.041）。结论：与18号针头相比，使用16号针头可降低获得不充分芯的风险。对于12岁以下的儿童，18G针头比16G针头更安全。16G针与18G针一样安全，适用于12岁以上儿童的原生肾活检。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Nephrology 医学-泌尿学与肾脏学

CiteScore

4.70

自引率

20.00%

发文量

465

审稿时长

1 months

期刊介绍： International Pediatric Nephrology Association Pediatric Nephrology publishes original clinical research related to acute and chronic diseases that affect renal function, blood pressure, and fluid and electrolyte disorders in children. Studies may involve medical, surgical, nutritional, physiologic, biochemical, genetic, pathologic or immunologic aspects of disease, imaging techniques or consequences of acute or chronic kidney disease. There are 12 issues per year that contain Editorial Commentaries, Reviews, Educational Reviews, Original Articles, Brief Reports, Rapid Communications, Clinical Quizzes, and Letters to the Editors.