Glomerular Yield in Ultrasound-Guided Native Kidney Biopsies in Pediatric and Adult Populations With Age-Stratified Subgroups.

BACKGROUND

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.

MATERIALS AND METHODS

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).

RESULTS

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).

CONCLUSIONS

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.