Real-time US guidance during renal biopsy in children: a different approach. Technical note.

To minimize procedural failures and complications, a real-time ultrasound (US) approach was developed for percutaneous renal biopsy in the pediatric population. With use of a 3- or 5-MHz transducer, the medial border of the kidney is localized and a line, which parallels the renal axis, is drawn on the skin. The lower pole and renal hilum are identified, and lines are drawn perpendicular to the long axis. After the patient is sedated, the entry site is selected above the lower pole. The transducer is placed on the child's side in an oblique transverse plane parallel to the axis of the kidney, the needle is guided into the renal cortex, and a specimen is obtained. Sixty-five biopsies were performed in 63 children. Fifty-five specimens were obtained from native kidneys. Success was achieved in all cases with only three minor complications. This approach appears to be an easy, safe, and accurate guide for renal biopsy in the pediatric population.