The Efficacy and The Complications of 16 Gauge Compared to 18 Gauge Semiautomatic Needles in Percutaneous Native Renal Parenchyma Biopsy

Background: Percutaneous renal biopsy (PRB) of native kidneys is an essential tool in the diagnosis and management of renal disease. Since its introduction, advancements have been made in biopsy technique to improve diagnostic yield while minimizing complications. This study aimed to compare the diagnostic efficacy and safety between 18-gauge and 16-gauge semi-automated biopsy needles, in ultrasound guided percutaneous native renal biopsy. Methods: This prospective diagnostic accuracy study included 100 patients who were candidates for native kidney parenchymal biopsies. The study included two equal groups based on needle size: size 16 and size 18. All studied cases were subjected to clinical evaluation, laboratory investigations, percutaneous renal parenchymal biopsy and microscopic pathological examination. Results: Univariate and multivariate analysis was done to predict insufficient samples. Needle size 18 was significantly associated with an increased risk of insufficient sample in the univariate model. In the multivariate analysis, needle size remained significantly associated with the risk of insufficient samples. It was associated with about 10 times increased risk of insufficient sample compared to size 16 (OR = 9.965, 95% CI: 1.123–88.457, P = 0.039), controlling for all other parameters. Conclusion: 16-gauge semiautomated needle provided superior diagnostic efficacy compared to the 18-gauge needle, with a significantly lower risk of insufficient samples. Despite its larger size, the 16-gauge needle demonstrated comparable safety profiles without an increased complication rate, making it a more effective and reliable choice for achieving optimal histopathological outcomes in renal biopsy procedures.