Renal biopsy in children: indications, technique and efficacy in 119 consecutive cases

Abstract

Consecutive renal biopsies were performed on native kidneys in 109 children and adolescents, aged 0.1-19.8 (mean 9.9) years (119 biopsies). Bleeding diatheses were excluded or treated pre-operatively with intravenous desmopressin acetate. Biopsies were performed by a radiologist under ultrasound imaging, using an automated spring-loaded device allowing selection of the length of the needle movement and score size. Diagnostically adequate tissue was retrieved in 118 of 119 (99.2%) biopsy procedures; 24-h post-biopsy ultrasonography disclosed a small haematoma of the biopsied kidney in 26% of the cases. No correlation was seen between the occurrence of haematoma and (treated) prolonged bleeding time or a decrease in the haemoglobin level. No major complications occurred. Newly developed macroscopic haematuria was reported by 7% and micturition pain by 7% of patients. Painful body movements were reported by 37%. We conclude that the use of ultrasound imaging and an automated gunshot technique is a safe and efficient method for performing renal biopsies in paediatric patients.

Safety and Complications of Percutaneous Kidney Biopsies in 715 Children and 8573 Adults in Norway 1988–2010

“…To our knowledge, the current study is the only nationwide registry-based and largest report of renal biopsy complications, and our findings confirm the general impression of low complication rates and improved safety of modern renal biopsy procedures (19). Similar low complication rates have been reported in recent studies (16,19,20) in contrast to earlier studies (reporting 5%-7% complication rates) (21)(22)(23)(24)(25). The crucial safety evaluation of kidney biopsies is characterized by the overall risk and frequency of major complications, which in our study, are defined as need of blood transfusion and/or surgery or catheterbased intervention (embolization) secondary to bleeding, and they should not be jeopardized by procedural events of minor clinical relevance.…”

Paediatric Renal Biopsies in East Bohemia. Single Centre Experience in the Years 1997–2008

“…Male predominance in biopsy-proven kidney diseases corresponds with the data published by other authors (1, 6, 8, 10, 25, 30, 31). The patients' mean age of 12.77 ± 4.17 years at the time of RB is very similar to most other observations, where the mean age ranged from 9 to13 years (1,7,12,15,20,23,30,35). The significantly lower age of patients with MCD and IgM nephropathy was related to the onset of NS, in particular steroid-dependent nephrotic syndrome.…”

“…We recorded similar (3,15,22) and even lower rates of post-biopsy complications compared with the experience of other authors (2,6,7,28,32).…”

Ultrasound-Guided Core Biopsy of the Kidneys in Infants and Children: Kuwait Experience

“…A similar observation has been reported by other authors using needles of identical gauges [5]. The adequacy of the biopsy material also compared favorably with other reports in the literature [6,7,12] regardless of the technique used [5,13].…”

“…A small perirenal hematoma was observed in 2 (5%) of our patients. Other authors [9] also reported a low incidence of this minor complication, though other minor complications like local pain or discomfort are not uncommon [6]. In patients with coagulation defects the risk of postbiopsy bleeding can be reduced by fresh frozen plasma infusion and vitamin K. Various sizes and types of needles have been used by different authors [4,10,11] with the aim to minimize bleeding complications.…”