PERCUTANEOUS kidney biopsy (PKB) has been shown to be a feasible and safe procedure when testing patients with small kidneys, according to new research. Ivan Zepeda Quiroz, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico, and colleagues, found that using PKB on these patients causes only an insignificant number of minor complications.
Kidney size has previously been considered a contraindication for PKB due to poor accessibility and risk of complications, and thus far, there has been no consensus on the best approach in this setting. In this retrospective cross-sectional study, 25 patients (19 females, six males) above the age of 16 years with a kidney length of ≤8 cm who had undergone a PKB of native kidneys from July 2019–December 2022 were analysed. Mean age of patients was 42.3 years, and mean kidney length was 7.56 cm, while mean kidney width was 4.2 cm. Sampling was performed in real time guided by ultrasound.
The team reported that an adequate sample was received in each PKB performed, with a total of five minor complications, including three perirenal haematomas, one haematuria, and one case of haematoma plus haematuria. The patients’ diastolic blood pressure before the procedure had the greatest association with these complications. Additionally, histological examinations showed a range of renal and glomerular conditions, including focal segmental glomerulosclerosis in 36%, lupus nephritis in 20%, crescentic glomerulonephritis in 16%, and tubulointerstitial nephritis in 12% of samples. Management was modified in 64% of the cases analysed.
The authors of the study concluded that PKB in small kidneys is a feasible and safe option, when properly planned, despite former beliefs that kidney size was a contraindication for PKB. The team reported that this study is clinically relevant since histological diagnosis was provided in all cases. This research provides evidence that using PKB is possible regardless of kidney size, which is essential for nephrologists, as PKB is a vital diagnostic tool.
