Percutaneous US-Guided Renal Biopsy in Children: A Single Center Experience

Background: Renal biopsy plays a fundamental role in clinical practice to establish morphological diagnosis, prognosis as well as in developing the appropriate therapy plain.
Objectives: The aim of this study was to assess the safety and efficacy of the real time US guided renal biopsy in children and to determine the optimal period of observation after renal biopsy as well as to evaluate the indications and histology of renal biopsies in our center.
Methods: PRB performed at the Pediatric Department, Tanta University Hospital between January 2007 to January 2011 with the real time US guidance were retrospectively analyzed. Post procedure complications that required surgical intervention or blood transfusion were considered "Major".
Results: A total of 8S renal biopsies were performed on 80 patients from native kidneys. Forty three patients were males (53.75%) with age range б month — l2 years and 37 female (46.25%) with age range I 15 year. Two cores from each patient were taken. A mean of 10 glomeruli were present in each specimen. The two cores were insufficient for diagnosis in 2 patients (2.35%) and at least one core was effective for diagnosis in 97.65% of procedures. Local pain (required analgesi) at site of biopsy was the most common minor complication seen post biopsy (70.58%). Transient grosshematuria was seen in 8 patients (9.4%) without urine retention. Major complications that required surgical intervention or blood transfusion did not occur. All complications were observed within 24 hours of biopsy. There was no difference in the rate of detection of patients with complications after 24 hrs. and 1 week. The main indication of renal biopsy was nephrotic syndrome and mesangioproliferative GN was the most common finding in light microscopic examination regardless the indication of biopsy while in children with nephrotic syndrome minimal change disease was the commonest finding.
Conclusion: PIlB using real time US guidance is a safe and effective procedure in children and can be done as one day case with 24 hrs. observation.