A prospective audit of complications in 100 consecutive pediatric percutaneous renal biopsies done under real-time ultrasound guidance

Sinha, Rajiv; Maji, Biplab; Sarkar, Biswadeep; Meur, Säumen

doi:10.4103/0971-4065.171232

Cited by 5 publications

(7 citation statements)

References 25 publications

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“…Factors as uremia, arterial hypertension, and autoimmune disease may have contributed to this complication development. In the present study, major complications prevalence is much lower compared to other reports 12 to 30.8% of the cases [ 18 , 32 , 33 ]. This allows us to conclude that, in our center, percutaneous renal biopsy is a safe procedure with a major complications prevalence of less than 5%, concordant to previously established standards [ 32 ].…”

Section: Discussioncontrasting

confidence: 76%

Characterization and Etiopathogenic Approach of Pediatric Renal Biopsy Patients in a Colombian Medical Center from 2007-2017

Rico

Cuellar

Hernandez

et al. 2018

International Journal of Nephrology

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Introduction Renal biopsy is the principal instrument to evaluate the diagnosis and prognosis of children with kidney disease. There are relatively few studies establishing epidemiology of its findings in the pediatric population. Methods A descriptive study was conducted to describe characteristics of pediatric patients who had undergone a renal biopsy over the last 10 years in a national reference center, trying to accomplish an etiopathogenic approach of biopsy findings. Results 241 patients were included. Most frequent indications were nephrotic syndrome (34.1%) and systemic disease with renal involvement (30.2%). The most prevalent biopsy diagnosis was glomerulonephritis (44%) and among these patients, glomerulonephritis mediated by immune complexes was the most frequent pathogenic type (90.5%). When the biopsy was indicated for proteinuria plus hematuria and systemic disease with renal involvement, the most frequent biopsy diagnosis was glomerulonephritis (60 and 85%, respectively). For isolated hematuria, the predominant biopsy diagnosis was inherited diseases of the glomerular basement membrane (70%) and for nephrotic syndrome, podocytopathy (82%). Glomerulonephritis was more frequent in patients older than 10 yrs (65%) and the rate of postbiopsy major complications was low (1.2%). ConclusionImmune complex glomerulonephritis was the most frequent histological finding, differing from previous reports. To our knowledge this is the first description that classifies biopsy findings according to the probable pathogenic mechanism.

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Section: Discussioncontrasting

confidence: 76%

Characterization and Etiopathogenic Approach of Pediatric Renal Biopsy Patients in a Colombian Medical Center from 2007-2017

Rico

Cuellar

Hernandez

et al. 2018

International Journal of Nephrology

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“…Hussain F et al achieved the standard for the number of needle passes in 86.4% cases 10 . Whereas the Norwegian study and Sinha R. et al reported adequate biopsy material by ≤2 attempt in 85% and 72 cases respectively 6,7 . BAPN standard for adequacy is >95%.…”

Section: Resultsmentioning

confidence: 88%

“…Incidence was less reported by Varnell C D et al and Tondel C.et al and proportion was 3.5%. and 1.7% respectively 7,14,6 . Reported need for blood transfusion after renal biopsy was 0.9%.…”

Section: Discussionmentioning

confidence: 93%

“…Reported need for blood transfusion after renal biopsy was 0.9%. Rasheed S. A. Al et al observed frequent gross haematuria (26%) after biopsy in children and 5 out of 32 children with gross hematuria required blood transfusion [6][7][8][9][10][11][12][13] .…”

Section: Discussionmentioning

confidence: 99%

“…The success of percutaneous renal biopsy is determined both by the adequacy of the tissue and the incidence of complications. Gross or macroscopic hematuria is the most frequent important major complication if it necessitates blood transfusion, surgical intervention/embolization or prolonged hospital stay 6,7 .…”

Section: Introductionmentioning

confidence: 99%

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Complications of Ultrasound Guided Renal Biopsy in 100 Children: Experience at a Tertiary Care Hospital

Quader

Biswas

Datta

et al. 2020

Chatt Maa Shi Hosp Med Coll J

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Background: Use of automated device with ultrasound guidance in renal biopsy has improved the adequacy and reduced the complication. Chittagong Medical College Hospital (CMCH) is a tertiary teaching hospital where Pediatric Nephrology Department started its journey on 11th December 2013. Since then renal biopsy is going on. Aim of the study is to see the rate of adequacy and complication of renal biopsy along the course of years. Materials and methods: This is a retrospective study carried on 100 consecutive ultrasonography guided percutaneous renal biopsy from lower pole of left native kidney performed by the pediatric nephrologist. All hospitalized children aged up to 12 years admitted since 2014 were included. Spring loaded automated biopsy needle was used in 88% cases and Trucut biopsy needle in 12% cases. Results: Most of the patients were aged between 1 to 10 years with male female ratio 0.9:1. Midazolam was used for sedation in all patients except one who needed general anesthesia. Light microscopy and Direct Immunofluorescence (DIF) report was made but no facility for electron microscopy. Gross hematuria was experienced in 5% cases and one case needed blood transfusion. There was one case with blood clot in urinary bladder causing dysuria but no urinary retention was observed. Post biopsy perinephric hematomas developed in 4 cases. Number of needle passes to obtain adequate biopsy material in native kidney was £3 in 78% cases. Adequate specimen was found in 95% cases. Conclusion: Percutaneous renal biopsy can be done adequately and safely in resource poor setup if pediatric nephrologist and radiologists are available. Chatt Maa Shi Hosp Med Coll J; Vol.19 (2); July 2020; Page 9-12

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Sonological predictors of complications of percutaneous renal biopsy—a prospective observational study

Bhattacharya,

Nagaraju,

Prabhu

et al. 2024

Ir J Med Sci

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Percutaneous renal biopsy, although essential for renal disease diagnosis, is associated with a number of post-biopsy complications ranging from gross haematuria to AV fistula to death. In this study, we carried out an active haematoma surveillance and attempted to correlate renal sonological parameters—kidney length, renal parenchymal changes, renal cortical and parenchymal thickness for their potential use in prediction of post-renal biopsy complications. Methods This was a prospective study done from April 2022 to April 2023 on all adult patients undergoing native or transplant kidney biopsy. Baseline clinical, laboratory and renal sonological parameters were noted prior to biopsy. USG-guided renal biopsy was done and any haematoma at 0 h, 12 h and 24 h post-biopsy noted. Biopsy complications including need for any interventions were noted. Results Out of the 240 patients enrolled in the study, 58.3% experienced post-biopsy complications. Among these, 5% of patients encountered major complications, with 3.33% necessitating medical intervention following renal biopsy procedures. A high percentage, 98.89%, exhibited hematoma formation within 12 h post-biopsy. Furthermore, our analysis revealed that a hematoma size exceeding 1.2 cm at the 12-h mark exhibited a sensitivity of 100% and specificity of 71% in predicting the need for blood transfusion. Renal parenchymal changes were the most reliable sonological parameters for predicting post-biopsy complication on multivariate analysis. Conclusion The incidence of major complications requiring interventions following renal biopsy is notably low. Our study highlights the significance of renal sonological characteristics, including parenchymal thickness, cortical thickness and parenchymal changes, in predicting these complications. Furthermore, we emphasize the utility of hematoma surveillance immediately post-biopsy and at the 12 h, as a valuable tool for predicting the necessity of post-biopsy interventions. This approach can aid in efficiently triaging patients and determining the need for further observation post-renal biopsy.

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A prospective audit of complications in 100 consecutive pediatric percutaneous renal biopsies done under real-time ultrasound guidance

Cited by 5 publications

References 25 publications

Characterization and Etiopathogenic Approach of Pediatric Renal Biopsy Patients in a Colombian Medical Center from 2007-2017

Characterization and Etiopathogenic Approach of Pediatric Renal Biopsy Patients in a Colombian Medical Center from 2007-2017

Complications of Ultrasound Guided Renal Biopsy in 100 Children: Experience at a Tertiary Care Hospital

Sonological predictors of complications of percutaneous renal biopsy—a prospective observational study

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