Ravizzini Pedro C, Lino Henrique A, de Faria Castro Fleury Eduardo, Toledo Luis Gustavo M
Department of Radiology, Faculty of Medical Sciences of Santa Casa de Misericordia de São Paulo, São Paulo, BRA.
Department of Urology, Faculty of Medical Sciences of Santa Casa de Misericordia de São Paulo, São Paulo, BRA.
Cureus. 2025 Aug 28;17(8):e91202. doi: 10.7759/cureus.91202. eCollection 2025 Aug.
This study compares the glomerular yield, mean number of biopsy cores, and complication rates between pediatric and adult populations undergoing ultrasound-guided native kidney biopsies. Additionally, the adult population was stratified into subgroups to further analyze age-related differences in glomerular yield and complication rates.
A retrospective cohort study was conducted using data from 431 native kidney biopsies performed between February 2008 and February 2021. Patients were divided into two main groups: pediatric (≤18 years old, n = 215) and adult (>18 years old, n = 216). Adult patients were further stratified into three subgroups: those aged >18 to 40 years old (n = 108), >40 to 60 years old (n = 72), and >60 years old (n = 36).
Pediatric patients had a higher mean number of glomeruli per core than adults (20.6 ± 12.3 vs. 15.7 ± 9.4; p < 0.001). Among adults, yield declined with age: 7.2 ± 9.8 (>18-40 years), 15.1 ± 9.1 (>40-60 years), and 13.8 ± 8.7 (>60 years) (p < 0.05). No difference in core numbers between pediatric and adults (2.4 ± 0.66 vs. 2.5 ± 0.66; p = 0.08) or among adult subgroups was observed. In the adult stratification group, the >18 to 40-year-old subgroup had the highest mean number of glomeruli (17.2 ± 9.8), followed by the >40 to 60-year-old (15.1 ± 9.1) and >60-year-old subgroups (13.8 ± 8.7) (p<0.05). Complication rates were low across all groups, with no significant differences observed between the pediatric and adult populations (12/215, 5.6% vs. 8/216, 3.7%; p = 0.454). Among the adult subgroups, the >18 to 40-year-old subgroup had the lowest complication rate (3/108, 2.8%), followed by the >40 to 60-year-old (3/72, 4.2%) and >60-year-old subgroups (2/36, 5.6%). However, these differences were not statistically significant (p = 0.512).
Pediatric patients exhibit a higher glomerular yield per biopsy core compared to adults, with no significant difference in the number of biopsy cores obtained. Among adults, younger patients (>18 to 40 years) demonstrate a higher glomerular yield compared to older age groups, suggesting that age may influence glomerular density and biopsy outcomes. Complication rates were low across all age groups, with no significant differences observed. These findings highlight the importance of considering age-related factors when performing native kidney biopsies to optimize diagnostic yield and minimize complications.
本研究比较了接受超声引导下经皮肾穿刺活检的儿童和成人的肾小球获取率、平均活检针数以及并发症发生率。此外，将成人人群分为亚组，以进一步分析肾小球获取率和并发症发生率与年龄相关的差异。
采用2008年2月至2021年2月期间431例经皮肾穿刺活检的数据进行回顾性队列研究。患者分为两个主要组：儿童组（≤18岁，n = 215）和成人组（>18岁，n = 216）。成人患者进一步分为三个亚组：年龄>18至40岁（n = 108）、>40至60岁（n = 72）和>60岁（n = 36）。
儿童患者每针获取的肾小球平均数量高于成人（20.6 ± 12.3对15.7 ± 9.4；p < 0.001）。在成人中，肾小球获取率随年龄下降：7.2 ± 9.8（>18 - 40岁）、15.1 ± 9.1（>40 - 60岁）和13.8 ± 8.7（>60岁）（p < 0.05）。未观察到儿童与成人之间（2.4 ± 0.66对2.5 ± 0.66；p = 0.08）或成人亚组之间活检针数的差异。在成人分层组中，>18至40岁亚组的肾小球平均数量最高（17.2 ± 9.8），其次是>40至60岁（15.1 ± 9.1）和>60岁亚组（13.8 ± 8.7）（p<0.05）。所有组的并发症发生率均较低，儿童和成人人群之间未观察到显著差异（12/215，5.6%对8/216，3.7%；p = 0.454）。在成人亚组中，>18至40岁亚组的并发症发生率最低（3/108，2.8%），其次是>40至60岁（3/72，4.2%）和>60岁亚组（2/36，5.6%）。然而，这些差异无统计学意义（p = 0.512）。
与成人相比，儿童患者每活检针的肾小球获取率更高，获取的活检针数无显著差异。在成人中，较年轻患者（>18至40岁）的肾小球获取率高于老年组，提示年龄可能影响肾小球密度和活检结果。所有年龄组的并发症发生率均较低，未观察到显著差异。这些发现强调了在进行经皮肾穿刺活检时考虑年龄相关因素以优化诊断获取率并最小化并发症的重要性。
