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Percutaneous real-time ultrasound-guided renal biopsy by automated biopsy gun in children: safety and complications.

BACKGROUND
Percutaneous renal biopsy under real time ultrasound guidance is a routine procedure in pediatric nephrology and allows a histological diagnosis to be made in children with evidence of renal disease.


METHODS
Retrospective case note review.


RESULTS
Over four years 191 renal biopsies were attempted in 116 patients; 186 biopsies were performed successfully: 102 native and 84 renal allografts. 151 renal biopsies were performed under sedation and 34 biopsies were performed under general anesthetic, one biopsy without sedation. Problems during sedation were recorded in 5/151 (3.3%) cases. All patients remained in hospital overnight for observation following the biopsy. Complications were reported in 23/185 (12%) of biopsies. Macroscopic hematuria was recorded in 13/185 (7%), presenting within 6-hours of biopsy, on first void, in 11 patients. Two patients developed macroscopic hematuria four and six days after the procedure. One patient with macroscopic hematuria required a single blood transfusion. Three patients developed urinary retention requiring catheterization for up to 48 hours post-procedure, two of whom also had macroscopic hematuria. Pain post procedure was reported in 7.6% episodes and was reported significantly more often with elective native biopsies.


CONCLUSIONS
Renal biopsy can safely be performed as a day care procedure, if patients are observed for six hours instead of 24-hours post biopsy.