Komatsu Hiroaki, Yamashita Tomohisa, Osanami Arata, Akazawa Chikako, Endo Kota, Tsugawa Shun, Kimura Ayumu, Miyamori Daisuke, Abe Koki, Takahashi Satoko, Gocho Yufu, Koyama Masayuki, Sato Tatsuya, Tanaka Marenao, Moniwa Norihito, Furuhashi Masato
Department of Cardiovascular, Renal, and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8556, Japan.
Department of Nephrology and Dialysis Therapy, Sapporo Central Hospital, Sapporo, Japan.
Clin Exp Nephrol. 2025 Jan;29(1):57-66. doi: 10.1007/s10157-024-02544-0. Epub 2024 Aug 22.
A streamlined and effective renal biopsy technique is essential for all nephrologists, particularly those who are less experienced, such as residents. Herein, we report the efficacy of a Straightforward and Immediate ultrasound-guided kidney biopsy using a Guide Needle (SIGN) technique, which allows operators to insert a biopsy gun through a guide needle placed into the fascia of the posterior abdominal wall.
A retrospective cross-sectional study was conducted at a nephrology training institution to compare the time spent on the procedure and the number of glomeruli obtained between a group using the SIGN (n = 81) and a group using the conventional ultrasound-guided kidney biopsy technique with a needle guide device (n = 143).
The median procedure time in the SIGN group (2 min, interquartile range [IQR]: 1-3 min) was significantly shorter than that in the conventional group (3 min, IQR: 2-4 min) (P < 0.001). Multivariable linear regression and logistic regression analyses adjusted for covariates, including operators (board-certificated nephrologists or nephrology residents), showed that the use of the SIGN technique was independently associated with a high number of glomeruli obtained and a procedure time above 2 min as the median value (odds ratio: 0.17, 95% confidence interval CI 0.09-0.34). The prevalence of complications was comparable between the two groups (P = 0.681).
The SIGN technique reduces the procedure time and obtains adequate biopsy tissue regardless of the operator's experience. SIGN can be applied in nephrology training programs and used as a standard biopsy technique.
一种简化且有效的肾活检技术对所有肾科医生来说至关重要，尤其是那些经验较少的医生，如住院医师。在此，我们报告一种使用引导针的直接即时超声引导肾活检（SIGN）技术的有效性，该技术允许操作者通过置于后腹壁筋膜的引导针插入活检枪。
在一家肾科培训机构进行了一项回顾性横断面研究，以比较使用SIGN技术的组（n = 81）和使用带针引导装置的传统超声引导肾活检技术的组（n = 143）在操作上花费的时间以及获得的肾小球数量。
SIGN组的中位操作时间（2分钟，四分位间距[IQR]：1 - 3分钟）显著短于传统组（3分钟，IQR：2 - 4分钟）（P < 0.001）。对包括操作者（获得委员会认证的肾科医生或肾科住院医师）等协变量进行调整的多变量线性回归和逻辑回归分析表明，使用SIGN技术与获得大量肾小球以及操作时间高于2分钟的中位值独立相关（优势比：0.17，95%置信区间CI 0.09 - 0.34）。两组并发症的发生率相当（P = 0.681）。
SIGN技术可缩短操作时间，且无论操作者经验如何都能获取足够的活检组织。SIGN可应用于肾科培训项目，并用作标准活检技术。
