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Purpose <p>To compare the efficacy of percutaneous ultrasound-guided renal biopsy using longitudinal and cross-sectional probe location cutting techniques, focusing on the adequacy of tissue sampling and potential complications.</p> Methods <p>In this single-center prospective randomized controlled trial (August 2023–January 2024), 70 patients with suspected renal parenchymal disease were randomly assigned to undergo biopsy using either a longitudinal (<i>n</i> = 35) or cross-sectional (<i>n</i> = 35) probe approach. Technical success was defined as obtaining ≥ 10 glomeruli. Outcomes included technical success, glomerular yield, and complications. Subgroup analyses were performed by cortical thickness (&lt; 10&#xa0;mm) and body mass index (BMI ≥ 30&#xa0;kg/m²). Multivariate logistic regression was used to identify predictors of success.</p> Results <p>Technical success was achieved in 30/35 patients (85.7%) in the cross-sectional group and 22/35 (62.9%) in the longitudinal group (<i>P</i> = 0.056). Median glomerular yields were similar (20 vs. 18, <i>P</i> = 0.173). Complication rates were low and comparable between groups (1/35 vs. 2/35 required angioembolization). Subgroup analyses suggested higher success rates for the cross-sectional approach in obese patients (100% vs. 50%, <i>P</i> = 0.105) and in those with cortical thickness &lt; 10&#xa0;mm (80% vs. 42.9%, <i>P</i> = 0.094), though these were not statistically significant. In multivariate analysis, the cross-sectional technique (OR: 7.69; 95% CI: 1.69–50; <i>P</i> = 0.006) and greater cortical thickness (OR: 1.49 per mm; 95% CI: 1.06–2.25; <i>P</i> = 0.019) were independently associated with success.</p> Conclusion <p>The cross-sectional probe technique was independently associated with higher technical success in renal biopsy without increasing complications. Given the modest sample size and borderline significance in univariate analysis, subgroup findings should be considered exploratory, and larger multicenter trials are warranted for validation.</p>

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Percutaneous ultrasound-guided kidney biopsy: a randomized controlled trial comparing longitudinal and cross-sectional probe location cutting techniques

  • 期刊论文

  • 发表日期：

    2025年10月24日

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  • Surasit Akkakrisee,
  • Keerati Hongsakul,
  • Suthasinee Arunwate,
  • Ussanee Boonsrirat,
  • Sorracha Rookkapan,
  • Jitpreedee Sungsiri,
  • Kittipitch Bannangkoon,
  • Phurich Janjindamai,
  • Panjai Choochuen

摘要

Purpose

To compare the efficacy of percutaneous ultrasound-guided renal biopsy using longitudinal and cross-sectional probe location cutting techniques, focusing on the adequacy of tissue sampling and potential complications.

Methods

In this single-center prospective randomized controlled trial (August 2023–January 2024), 70 patients with suspected renal parenchymal disease were randomly assigned to undergo biopsy using either a longitudinal (n = 35) or cross-sectional (n = 35) probe approach. Technical success was defined as obtaining ≥ 10 glomeruli. Outcomes included technical success, glomerular yield, and complications. Subgroup analyses were performed by cortical thickness (< 10 mm) and body mass index (BMI ≥ 30 kg/m²). Multivariate logistic regression was used to identify predictors of success.

Results

Technical success was achieved in 30/35 patients (85.7%) in the cross-sectional group and 22/35 (62.9%) in the longitudinal group (P = 0.056). Median glomerular yields were similar (20 vs. 18, P = 0.173). Complication rates were low and comparable between groups (1/35 vs. 2/35 required angioembolization). Subgroup analyses suggested higher success rates for the cross-sectional approach in obese patients (100% vs. 50%, P = 0.105) and in those with cortical thickness < 10 mm (80% vs. 42.9%, P = 0.094), though these were not statistically significant. In multivariate analysis, the cross-sectional technique (OR: 7.69; 95% CI: 1.69–50; P = 0.006) and greater cortical thickness (OR: 1.49 per mm; 95% CI: 1.06–2.25; P = 0.019) were independently associated with success.

Conclusion

The cross-sectional probe technique was independently associated with higher technical success in renal biopsy without increasing complications. Given the modest sample size and borderline significance in univariate analysis, subgroup findings should be considered exploratory, and larger multicenter trials are warranted for validation.