同轴与非同轴经皮肾活检：并发症、肾小球获取率及超声参数的作用

RATIONALE AND OBJECTIVES: Percutaneous renal biopsy (PRB) is essential for diagnosing renal parenchymal diseases, providing prognostic information and guiding treatment. However, biopsy-related complications remain a concern. PRB can be performed using coaxial or non-coaxial techniques. This study compared complication rates and technical success between these techniques and evaluated the effect of sonographic parameters on biopsy-related complications.

MATERIALS AND METHODS: In this retrospective single-center study, 210 adult patients who underwent native kidney PRB between October 2022 and February 2025 were included. PRB was performed using 18-gauge core biopsy needles with either coaxial (n = 108) or non-coaxial (n = 102) techniques. Sonographic parameters, including kidney length, parenchymal thickness, and parenchymal changes, were recorded before biopsy. Clinical and laboratory data, number of cores, glomerular yield, and complications were analyzed. Complications were classified as minor or major.

RESULTS: No significant differences were found between groups in age, sex, hemoglobin levels and changes, complication rates, or angiography requirement. Major complications occurred in 5.2% and minor complications in 20% of patients, with no significant difference between groups. Glomerular yield and the number of glomeruli per core were significantly higher in the coaxial group (p < 0.001 and p = 0.045, respectively). Increased renal parenchymal echogenicity was associated with a higher risk of complications.

CONCLUSION: The coaxial technique provided higher glomerular yield than the non-coaxial technique while maintaining similarly low complication rates. Increased renal parenchymal echogenicity was associated with complications following PRB.