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Kidney Week

Abstract: SA-PO142

Association of Kidney Biopsy Needle Gauge with Post-Procedure Complications and Biopsy Adequacy

Session Information

Category: Acute Kidney Injury

  • 102 AKI: Clinical, Outcomes, and Trials

Authors

  • Garg, Kanika K., Clinical and Translational Research Accelerator, New Haven, Connecticut, United States
  • Staunton, Mary Kate, Clinical and Translational Research Accelerator, New Haven, Connecticut, United States
  • Kent, Candice, Clinical and Translational Research Accelerator, New Haven, Connecticut, United States
  • Shaw, Melissa M., Clinical and Translational Research Accelerator, New Haven, Connecticut, United States
  • Wilson, Francis Perry, Clinical and Translational Research Accelerator, New Haven, Connecticut, United States
  • Moledina, Dennis G., Clinical and Translational Research Accelerator, New Haven, Connecticut, United States
Background

Narrower kidney biopsy gauge needles are thought to lead to fewer post-biopsy complications but could risk inadequate sampling for diagnosis. We examine the association of needle gauge with post-biopsy complications and sampling adequacy.

Methods

Using data from participants enrolled in the Yale biopsy cohort between 7/2020 and 4/2023, we tested the association of needle gauge (16G vs. 18 or 20G) with biopsy-related complications and number of glomeruli sampled using a chi-squared test for proportions for categorical outcomes or a Wilcoxon rank sum test for continuous outcomes.

Results

Of the 511 adult participants, median age was 60 (43,70), 49% were female, 60% were White, 33% were hospitalized and 52% underwent a biopsy for acute kidney injury. Those with 18G were more likely to have AKI (60% vs. 48%, P=0.01) and be hospitalized (40% vs. 29%, P=0.007). Needle gauge was not associated with seeking adverse post-biopsy complications, but participants who underwent a biopsy with narrower needle gauge required more imaging studies after biopsy (21% vs. 11%, p=0.004) primarily driven by concerns of hemoglobin drop. Narrower needle gauge was associated with fewer glomeruli available for diagnosis (11.5 [7.0-17.0] vs 14.0 [9.0-20.0], p<0.001).

Conclusion

Our data show that the narrower gauge biopsy needle was associated with fewer glomeruli available for diagnosis and greater need for postoperative imaging. However, we cannot rule out confounding by indication such that those at higher risk of complications underwent biopsy with narrower needle gauge. Further investigation into the complications associated with biopsy needle size controlling for detailed risk factors for post-biopsy complications is needed to confirm these findings.

Funding

  • NIDDK Support