Yield and complications of kidney biopsy over two decades in a tertiary pediatric center

Feins, Roei Hod; Tobar, Anna; Davidovits, Miriam

doi:10.1111/ped.13182

Cited by 10 publications

(9 citation statements)

References 15 publications

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“…With regard to the size and age of the patient, the degree of complications can be reduced by selecting the appropriate needle size and the limiting biopsy attempts. Performing biopsies by radiologists or nephrologists is another cause of the difference in the frequency of the complications (20). The results of the meta-analysis by Varnell et al showed that biopsy in children is safe, since only 11% of patients had hematuria and less than 1% needed blood transfusions.…”

Section: Discussionmentioning

confidence: 99%

Pathologic findings of renal biopsies in children; an 11-year experience from a single center in West of Iran

2020

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Background: Renal biopsy is an important diagnostic procedure in pediatric nephrology. Although considered as an invasive method, numerous renal diseases cannot be definitively diagnosed and treated without it. Objectives: The aim of this study was histopathological study of renal biopsy results in children of 6 months to 18 years old. Patients and Methods: In this retrospective cross-sectional study, the available data from children who had undergone kidney biopsy between 2007 and the end of 2017 were evaluated. Demographic data, indications of biopsy, the outcome of patients, biopsy complications and histopathologic findings were collected using a checklist. Finally, data were presented as frequency and percentages. Results: The most common cause of biopsy in children was nephrotic syndrome (43.7%). Focal segmental glomerulosclerosis (FSGS) with 39 cases (32.7%) had the highest frequency in examined biopsies. In the long-term follow-up, 71 children (59.7%) cured, 7 (5.9%) died, 25 (21.0%) continued treatment, 6 (5.0%) underwent a kidney transplant surgery, and the outcome of 10 children (8.8%) was unknown. While 6.7% of patients were diagnosed with complications of biopsy, the most frequent of them was hematuria. There was no case of death or nephrectomy and only one patient needed packed RBC transfusion. Conclusion: Nephrotic syndrome was the most common indication for kidney biopsy. FSGS had the highest frequency in examined biopsies.

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Section: Discussionmentioning

confidence: 99%

Pathologic findings of renal biopsies in children; an 11-year experience from a single center in West of Iran

2020

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“…9 In another study, only (3/30) cases had complications like pneumonia secondary to i m m o b i l i s a t i o n , p e r i t o n i t i s a n d m i n i m a l parenchymal haemorrhage in each of the cases. 10 Similarly, in yet another study, the most common indication for renal biopsy was nephrotic syndrome (34.7%), followed by nephritic nephrotic syndrome (20%). Minimal change disease was the commonest pathological findings among nephrotic syndrome a n d a m o n g n o n -n e p h r o t i c p r i m a r y glomerulonephritis, IgA nephritis was the commonest findings.…”

Section: Discussionmentioning

confidence: 83%

Role of Renal Biopsy in Managing Paediatric Renal Disease in a Tertiary Care Setting

Yadav

Thakur

2021

J. Nepal Paedtr. Soc.

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Introduction: The contribution of renal biopsy is of major importance in many paediatrics renal diseases. This prospective study analysed the clinic-pathological spectrum of the biopsied cases, complications related to renal biopsy and its effect on management. Methods: USG guided percutaneous renal biopsy was performed in indicated children. Laboratory findings, complications of the procedure, histological diagnosis and its effect on management were obtained from all patients who underwent renal biopsy from April 2019 to March 2020. The data were finally analysed using descriptive statistics. Results: Total 50 cases were enrolled during the study period. There were 24 males and 26 females with age range from two to 16 years. The common indications for biopsy were acute nephritic syndrome (25 cases), including both primary glomerulonephritis (11 cases) and secondary glomerulonephritis (14 cases), of which lupus nephritis contributed (11/25) cases, followed by atypical/ steroid resistant or dependent nephrotic syndrome (18 cases). Among primary glomerulonephritis, diffuse proliferative glomerulonephritis was most common pathological finding (11/25). One had crescentric glomerulonephritis. Lupus nephritis predominantly had Class IV/V pathology (6/11). Of 18 nephrotic syndrome cases, nine had minimal-change-disease and five had focal-segmental-glomerulosclerosis. The complications associated with procedure were self-resolving gross hematuria in eight cases, perirenal hematoma requiring plasma transfusion in one case. Adequate renal tissue sample was obtained in 47 of the renal biopsies. Three cases underwent repeat biopsy. Immunosuppressive therapy was altered as per the biopsy report among 18 cases. Conclusions: Our study showed that renal biopsy is a safe, reliable and effective technique in children. It resolutes many diagnostic dilemma and helps in effective management.

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“…After the removal of duplicates, 5004 unique records were identified, of which 4814 records were excluded after the screening of titles and abstracts. Of the 190 remaining studies, 72 studies (40 082 biopsies) 2,3,9,14,25-92 were included in the systematic review and meta-analysis after full-text review (Figure 1) including 4 single-center randomized controlled trials, 3 multicenter cohort studies (1 mixed retrospective-prospective and 2 retrospective), and 65 single-center cohort studies (10 prospective, 1 mixed retrospective-prospective, 46 retrospective, and 8 unreported). Details of the included studies are presented in Table S1, SDC, http://links.lww.com/TP/C332.…”

Section: Resultsmentioning

confidence: 99%

Complications of Percutaneous Kidney Allograft Biopsy: Systematic Review and Meta-analysis

Lim

Tan

et al. 2022

Transplantation

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Background. Kidney biopsy is important to guide the management of allograft dysfunction but has a risk of complications. This review aimed to determine the incidence and risk factors of complications after kidney allograft biopsy. Methods. This is a systematic review and meta-analysis of randomized controlled trials, cohort studies, or case-control studies indexed on PubMed, Embase, Cochrane Central Register of Controlled Trials, World Health Organization International Clinical Trials Registry, and ClinicalTrials.gov, limited to the English language, from January 2000 to December 2020, including adult and pediatric kidney allograft biopsies. Primary outcomes were gross hematuria, bleeding requiring transfusion, and major complications (requiring interventions such as blood transfusion or surgical or radiological interventions). Results. The review included 72 studies (40 082 biopsies). The quality of included studies was suboptimal. Pooled rates of gross hematuria, bleeding requiring transfusion, and major complications were 3.18% [95% confidence interval (95% CI), 2.31-4.19], 0.31% (95% CI, 0.15-0.52) and 0.89% (95% CI, 0.61-1.22), respectively. Gross hematuria rates were lower in high-income compared with middle-income countries (2.59% versus 6.44%, P < 0.01) and biopsies performed by radiology as compared with nephrology departments (1.25% versus 3.71%, P < 0.01). Blood transfusion rates were lower in pediatrics than adults (0.0% versus 0.65%, P < 0.01). Major complications were lower in biopsies performed by specialists as compared with trainees (0.02% versus 3.64%, P < 0.01). Graft loss and mortality were extremely rare. Limitations included missing data, few randomized controlled trials, and possible publication bias. Conclusions. The risk of complications after kidney allograft biopsy was low. Given the low quality of included studies, risk factors for complications should be further examined in future studies.

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Yield and complications of kidney biopsy over two decades in a tertiary pediatric center

Abstract: Kidney biopsy is an efficient and safe procedure in both native and transplanted kidneys and provides helpful diagnostic information in most cases in which it is deemed necessary.

Cited by 10 publications

References 15 publications

Pathologic findings of renal biopsies in children; an 11-year experience from a single center in West of Iran

Pathologic findings of renal biopsies in children; an 11-year experience from a single center in West of Iran

Role of Renal Biopsy in Managing Paediatric Renal Disease in a Tertiary Care Setting

Complications of Percutaneous Kidney Allograft Biopsy: Systematic Review and Meta-analysis

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