ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005


The Latest on Twitter

Kidney Week

Abstract: TH-PO586

Potential Factors for Specimen Adequacy and Bleeding Complications of Ultrasound-Guided Renal Biopsy

Session Information

  • Pathology and Lab Medicine
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

  • 1700 Pathology and Lab Medicine


  • Thammavaranucupt, Kanin, Chakri Naruebodin Medical Institute, Bang Phli, Samut Prakan, Thailand
  • Spanuchart, Ittikorn, Mahidol University Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand

A kidney biopsy is indicated for establishing a definite diagnosis and guiding the treatment of various kidney diseases. While obtaining adequate tissue is important, procedure-related risks, particularly bleeding, need to be minimized. The angle and depth of the biopsy needle trajectory have been studied for the safety outcome however the data on tissue adequacy associated with these factors is little. We aimed to evaluate potential factors, including the needle cortical tangential angle and the needle-distance ratio, for tissue adequacy and complications in native kidney biopsy.


A retrospective study was conducted on adult patients who underwent ultrasound-guided native kidney biopsy by interventional radiologists at Ramathibodi Hospital between January 1st, 2016, and December 31th, 2020. Clinical, imaging and technical parameters were collected for analysis.


Of 124 kidney biopsies, the demographic data includes the mean age of 51.5 years, male sex of 57.3%, BMI of 27.2 kg/m2, kidney size of 4.9x9.9 cm, the parenchymal thickness of 1.3 cm, increased echogenicity 73.4%, and loss of corticomedullary differentiation 44.4%. The parenchymal thickness of the adequate group was higher than the suboptimal/inadequate groups (p=0.056). Loss of corticomedullary differentiation was higher in the suboptimal/inadequate group (p=0.045). The needle cortical tangential angle in the range of 30-60° yielded tissue adequacy of 64% compared to 16% with the angle out of range (p<0.01). The mean needle-distance ratios of the adequate, suboptimal, and inadequate groups were 0.64, 0.74, and 0.79 cm, respectively (p=0.01). Major bleeding occurred at 13.7%. In multivariable analysis, needle cortical tangential angle was statistically significant for the tissue adequacy outcome.


Our study showed the cortical tangential approach with the angle between 30°-60° had higher tissue adequacy than the angle out of 30°-60°. The needle-distance ratio toward one, loss of corticomedullary differentiation, and decreased parenchymal thickness showed a tendency of having suboptimal or inadequate tissue.