Predictive Value of Ultrasound in the Detection of Complications After 1 Hour of Renal Biopsy.

Document Type : Original Article

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Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt.

Abstract

Introduction: Renal biopsy became a standard technique in diagnosing renal diseases. It had many complications in the past being performed blindly. But since the presentation of ultrasound-directed renal biopsy in the field, the procedure became much safer with less complication rate and better yield.
Aim of the study: In this work, we aim to assess the capability of ultrasound examination to detect early complications after one hour of renal biopsy and predict the course of cases.
Methods: This is a prospective study performed during the period from October 2017 to the end of March 2018, and included cases experiencing Percutaneous Renal Biopsy in the Pediatric Nephrology Unit at Cairo University Children’s Hospital.
Results: The present work enrolled 60 patients; 29-male (48.3%) and 31-female (51.7%); their mean weight was 24.2 kg, with a mean age of 89.3 months. Out of 60 patients who performed the biopsy, only 21.6% had complications. We detected two cases with subcapsular hematomas (3.3%), another 2 cases with bladder hematoma (3.3%), 9 cases with back pain (15%) and gross hematuria (as a complication, not related to original disease) occurred in 6 cases (10%). We found that the sensitivity of ultrasound is 66.6% in the first hour after renal biopsy with 98.3 % specificity to possible bleeding complications with 66.6% positive predictive value (PPV) and 98.2% negative predictive value (NPV). However clinical presentation was the only predictor in one case for complication which was detected late by ultrasound.
Conclusion: Our study suggests that combined ultrasound and clinical examination in the first hour after renal biopsy is the best indicator of postrenal biopsy complications.

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