COMPLICATIONS AND SAFETY OF POST PERCUTANEOUS RENAL BIOPSY SHORT STAY IN PAEDIATRIC PATIENTS
AbstractBackground: Renal biopsy is gold standard in diagnosis of various renal diseases. Though it is safe yet it requires adequate patient evaluation, preparation and monitoring after the procedure. Methods: This descriptive case series was conducted in the Paediatric Nephrology Department, The Children’s Hospital Lahore over a period of one year. Children aged less than 16 years were included who were suffering from renal diseases requiring renal biopsy for diagnosis. After renal biopsy patients were monitored for complications and were discharged after short stay of eight hours who got no complication during the observation period. Results: Out of total 145 patients, 97 (66.1%) were males and 48 (33.9%) were females. The age range was from 0.7 years to 16 years. The duration of stay after renal biopsy was up to eight hours in 131 (90.34%) patients, while 14 (9.66%) stayed longer. Post-biopsy stay of 24 hours was observed in 8 patients and 48 hours in 5 patients. Only 1 patient stayed for 96 hours. Patients with gross haematuria were 6 (4.1%) who were checked for perinephric hematoma formation by ultrasonography. Only one patient required blood transfusion along with fresh frozen plasma. The most common histopathological diagnosis was Mesangioproliferative with 67(46.2%) cases, followed by Glomerulonephritis in 35(24.1%) patients having Membranoproliferative Glomerulonephritis (MPGN) while Systemic Lupus Erythematous (SLE) nephritis was reported in 15 (10.35%) patients. Conclusion: Patients can be discharged after short stay post renal biopsy procedure provided done after proper screening of patients. As it not only reduces patient stay but also is cost effective.Keywords: Renal Biopsy, short stay, haematuria, complications
Al Makdama A, Al-Akash S. Safety of percutaneous renal biopsy as an outpatient procedure in paediatric patients. Ann Saudi Med 2006;26(4):303–5.
Cameron JS, Hicks J. The introduction of renal biopsy into nephrology from 1901 to 1961: A paradigm of the forming of nephrology by technology. Am J Nephrol 1997;17:347–58.
Iversen P, Brun C: Aspiration biopsy of the kidney. Am J Med 1951;11:324–30.
Feneberg R, Schaefer F, Zieger B, Walderr R, Mehls O, Schärer K. Percutaneous renal biopsy in children: a 27-year experience. Nephron 1998;79(4):438–46.
Donovan KL, Thomas DM, Wheeler DC, Macdougall IC, Williams JD: Experience with a new method for percutaneous renal biopsy. Nephrol Dial Transplant 1991;6(10):731–3.
Wiseman DA, Hawkins R, Numerow LM, Taub KJ. Percutaneous renal biopsy utilizing real time, ultrasonic guidance and a semiautomated biopsy device. Kidney Int 1990;38:347–9.
Manno C, Strippoli GF, Arnesano L, Bonifati C, Campobasso N, Gesualdo L et al. Predictors of bleeding complications in percutaneous ultrasound-guided renal biopsy. Kidney Int 2004;66:1570–7.
Soares SM, Fervenza FC, Lager DJ, Gertz MA, Cosio FG, Leung N. Bleeding complications after transcutaneous kidney biopsy in patients with systemic amyloidosis: Single-center experience in 101 patients. Am J Kidney Dis 2008;52(6):1079–83.
Mendelssohn DC, Cole EH: Outcomes of percutaneous kidney biopsy, including those of solitary native kidneys. Am J Kidney Dis 1995;26(4):580–5.
Conley SB. Renal biopsy in the 1990s. Pediatr Nephrol 1996;10(4):412–3.
Fraser IR, Fairley KF. Renal biopsy as an outpatient procedure. Am J Kidney Dis 1995;25(6):876–8.
Marwah DS, Korbet SM. Timing of complications in percutaneous renal biopsy: what is the optimal period of observation? Am J Kidney Dis 1996;28(1):47–52.
Khajehdehi P, Junaid SMA, Salias-Madrigal L, Schmitz PG, Bastani B. Percutaneous renal biopsy in the 1990s: safety, value, and implications for early hospital discharge. Am J Kidney Dis 1999;34(1):92–7.
Alon U, M Perry. Percutaneous kidney needle biopsy in children is less traumatic than in adults. Nephron 1988(1);50:57–60.
Davis ID, Oehlenschlager W, O’Riordan MA, Avner ED. Pediatric renal biopsy: should this procedure be performed in an outpatient setting? Pediatr Nephrol 1998;12(2):96–100.
Whittier WL: Complications of the Percutaneous Kidney Biopsy. Adv Chronic Kidney Dis 2012;19(3):179–87.
Chung S, Koh ES, Kim SJ, Yoon HE, Park CW, Chang YS, et al. Safety and tissue yield for percutaneous native kidney biopsy according to practitioner and ultrasound technique. BMC Nephrology 2014;15:96-101.
Tondel C,Vikse BE, Bostad L, Svarstad E. Safety and Complications of Percutaneous Kidney Biopsies in 715 Children and 8573 Adults in Norway1988–2010. Clin J Am Soc Nephrol 2012;7:1591-7.
Golay V, Sarkar D, Thomas P, Trivedi M, Singh A, Roychowdhary A, et al. Safety and feasibility of outpatient percutaneous native kidney biopsy in the developing world: Experience in a large tertiary care centre in Eastern India. Nephrology 2013;18:36–40.
Corapi KM, Chen JLT, Balk EM, Gordon CE. Bleeding Complication of Native Kidney Biopsy: A Systematic Review and Meta-analysis. Am J Kidney Dis. 2012;60(1):62–73.
Franke M, Kramarczyk A, Taylan C, Maintz1 D, Hoppe B, Koerber F. Ultrasound-Guided Percutaneous Renal Biopsy in 295 Children and Adolescents: Role of Ultrasound and Analysis of Complications. PLoS ONE 2014;9(12): e114737.
Tse Y, Yadav P, Herrema I, Ognjanovic M, Moghal N, Coulthard MG. Performing renal biopsies in children under general anaesthesia in the lateral position. Pediatr Nephrol 2013;28(4):671–3.
Korbet SM, Volpini KC, Whittier WL. Percutaneous renal biopsy of native kidneys: a single-center experience of 1,055 biopsies. Am J Nephrol 2014; 39:153–62.
Simard-Meilleur MC, Troyanov S, Roy L, Dalaire E, Brachemi S. Risk factors and timing of native kidney biopsy complications. Nephron Extra 2014;4(1):42–9.
McMahon GM, McGovern ME, Bijol V, Benson CB, Foley R, Munkley K, et al. Development of an outpatient native kidney biopsy service in low-risk patients: a multidisciplinary approach. Am J Nephrol 2012;35:321–6.
Jiang SH, Karpe KM, Talaulikar GS. Safety and predictors of complications of renal biopsy in the outpatient setting. Clin Nephrol 2011;76:464–9