Safety profile of paediatric percutaneous ultrasonography-guided renal biopsies

Skalova S, Rejtar P
Correspondence: Dr Sylva Skalova, skalovasylva@seznam.cz

ABSTRACT
Introduction Renal biopsy (RB) is a decisive diagnostic procedure for patients with renal disease. Our aim was to assess the safety of RB and the prevalence of associated clinical complications.
Methods A total of 166 RBs were performed in 164 children (88 boys, 76 girls) in East Bohemia in 1997–2007. The mean age of the children was 12.9 +/- 4.1 years. All RBs were performed by a single consultant nephrologist. 27 biopsies were performed in 27 patients (16.3 percent) in 1997 under radiography control, while the remaining 139 biopsies (83.7 percent) were performed under ultrasonographic guidance. Renal ultrasonography (USG) following RB was not a general rule in patients who were biopsied under radiography control before 1998; therefore, only the USG results in patients after USG-guided RB (n = 139) were evaluated.
Results No major complications were encountered, and only minor complications occurred in 39 (23.5 percent) patients, which did not require medical intervention. The most common complication was asymptomatic perirenal haematoma, which was detected by USG one to three days after a USG-guided RB (30 out of 139 biopsies; 21.6 percent). Perirenal haematoma accompanied by abdominal pain occurred in two (1.4 percent) patients. Macroscopic haematuria was present in seven (4.2 percent) patients on Days 1–3 post biopsy. The complications were neither age-dependent nor were they related to the serum creatinine levels.
Conclusion The results obtained are consistent with those in other reports of paediatric patients. The absence of major complications is a favourable outcome. Thus, the present practice of USG-guided percutaneous RB in children is safe and clinically beneficial.

Keywords: haematuria, perirenal haematoma, post-biopsy complications, renal biopsy
Singapore Med J 2010; 51(6): 481-483