Percutaneous Renal Biopsy in Children: A 27-Year Experience

Abstract

Background: The introduction of automated biopsy devices and the localization of the kidney by ultrasound were aimed at optimizing efficacy and safety of the percutaneous renal biopsy procedure. We evaluated these technological advances in our renal biopsies performed in children. Methods: We sequentially used the Silverman needle (1969–1974), the TruCut needle (1974–1990), and the automated Biopty device (1990–1996). Fluoroscopy was used to localize the kidney until 1985, ultrasound examination prior to biopsy from 1985 to 1992, and direct ultrasound guidance since 1992. A total of 962 native kidney biopsies and 119 allograft biopsies were performed. Results: In the native kidney biopsies, the introduction of the Biopty device and ultrasound guidance were independently associated with fewer passes required to obtain adequate tissue and more glomeruli per specimen. The rate of biopsies yielding more than 9 glomeruli increased from 69 to 92% (p < 0.05). The number of glomeruli harvested per centimeter core length was inversely related to patient age (p < 0.01). More appropriate cortical tissue was retrieved in renal allograft biopsy specimens with the application of the new techniques. The occurrence of macroscopic hematuria (9.6%) in the native kidney biopsies was not affected by the puncture or localization technique applied, but subcapsular hematomas were documented more often with the Biopty device (42%) than with the TruCut needle (16%), probably due to improved ultrasound equipment. In the whole series 2 patients died, and 3 others required renal surgery and 4 blood transfusions. Conclusions: The automated ultrasound-guided procedure is a feasible and reliable technique for percutaneous renal biopsy in children. It gives a greater yield of diagnostic tissue without increasing the rate of clinical complications.

Assessment of Ten-Year-Long Results of Kidney Biopsies Performed on Children in the Thrace Region of Turkey

“…The complication rates in different series may be as low as 2.6% or as high as 43% (9)(10)(11)(12)(13)(14)(15). In our biopsy series, the success and complication rates did not differ from most of the studies on children.…”

Renal biopsy: Still a landmark for the nephrologist

“…July 6, 2016|Volume 5|Issue 4| WJN|www.wjgnet.com Fenerberg et al [24] 1998 1081 9.6 1.11 0.09 Prasad et al [28] 1998 1090 3 0.36 0 Preda et al [20] 2003 515 9.5 2.7 0 Whittier et al [51] 2004 750 6.7 6.4 0.13 Atwell et al [44] 2010 5832 -0.7 0 Stratta et al [29] 2007 1137 24.2 0.36 0 Korbet et al [23] 2014 1055 8.1 6.6 0.09 Mai et al [21] 2013 934 5.9 0.86 0 Tøndel et al [13] 2012 9288 1.9 0.9 0 Prasad et al [28] 2015 2138…”

Rare but Feared Complications of Percutaneous Renal Biopsy: Arteriovenous Fistula and Pseudoaneurysm

“…Mikroskobik hematüri ve perirenal hematom gibi minör komplikasyonlar genellikle biyopsi sonrası birkaç hafta içinde düzelirken, AVF'nin %70'inin ilk biriki yıl içinde spontan olarak gerilediği, %30'unun ise ilerleyip semptomatik olduğu bildirilmiştir. 6,7 AVF gelişen hastaların kliniği sessiz olabileceği gibi yan ağrısı, makroskobik hematüri, hipertansiyon, abdominal arteriyel üfürüm, yüksek debili kalp yetmezliği, böbrek fonksiyonlarında bozulma ve hayatı tehdit eden ciddi kanamaya sebep olabilir. 8 Bizim olgumuzda AVF açısından şüphe uyandıran patolojik bulgular ise biyopsinin yapıldığı tarafta yan ağrısı ve makroskobik hematüri idi.…”