Jhao-Jhuang Ding1,2, Shih-Hua Lin3, Jing-Long Huang4, Tai-Wei Wu5, Shao-Hsuan Hsia6, Jainn-Jim Lin6, Yu-Ching Chou7,8, Min-Hua Tseng9. 1. Division of Nephrology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, No 5, Fu-Shing ST., Kwei-Shan, Taoyuan, Taiwan. 2. Department of Pediatrics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 3. Department of Nephrology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. 4. Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 5. Fetal and Neonatal Institute, Division of Neonatology Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 6. Division of Pediatric Critical Care Medicine, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan. 7. School of Public Health, National Defense Medical Center, Taipei, Taiwan. 8. Division of Nephrology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan. 9. Division of Nephrology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University, No 5, Fu-Shing ST., Kwei-Shan, Taoyuan, Taiwan. doc31089@gmail.com.
Abstract
BACKGROUND: Percutaneous ultrasound-guided renal biopsy (PURB) is an invasive but essential procedure in establishing the histologic diagnosis of pediatric renal diseases. Large studies which describe PURB complications and its contributory risk factors are scarce in the pediatric literature. METHODS: Patients who underwent real-time PURB from September 2011 to August 2017 were retrospectively reviewed. Data pertaining to clinical characteristics, histologic diagnosis and biopsy-related complications were collected. In addition, the risk factors for complications were also analyzed. RESULTS: Overall, 183 patients (109 females) were enrolled and 201 biopsies were obtained. The mean age was 14.4 ± 13.7 years. Over 98% of the biopsies were considered adequate in quality. The major complications were perirenal hematoma requiring blood transfusion (4 cases, 2.0%), followed by perirenal abscess (1 case, 0.5%) and arteriovenous fistula (1 case, 0.5%). All patients recovered without sequelae after treatment. Hypertension, low estimated glomerular filtration rate (eGFR) and anemia were more common in patients with complication than in those without. Further logistic regression model analysis demonstrated that eGFR <30 ml/1.73m2/min was an independent risk factor for major complications. CONCLUSIONS: Perirenal hematoma needing blood transfusion is the most common major complication for children undergoing renal biopsy. Low eGFR is an independent risk factor for major complications. Early recognition and timely treatment should be delivered to children with renal function impairment accordingly.
BACKGROUND: Percutaneous ultrasound-guided renal biopsy (PURB) is an invasive but essential procedure in establishing the histologic diagnosis of pediatric renal diseases. Large studies which describe PURB complications and its contributory risk factors are scarce in the pediatric literature. METHODS:Patients who underwent real-time PURB from September 2011 to August 2017 were retrospectively reviewed. Data pertaining to clinical characteristics, histologic diagnosis and biopsy-related complications were collected. In addition, the risk factors for complications were also analyzed. RESULTS: Overall, 183 patients (109 females) were enrolled and 201 biopsies were obtained. The mean age was 14.4 ± 13.7 years. Over 98% of the biopsies were considered adequate in quality. The major complications were perirenal hematoma requiring blood transfusion (4 cases, 2.0%), followed by perirenal abscess (1 case, 0.5%) and arteriovenous fistula (1 case, 0.5%). All patients recovered without sequelae after treatment. Hypertension, low estimated glomerular filtration rate (eGFR) and anemia were more common in patients with complication than in those without. Further logistic regression model analysis demonstrated that eGFR <30 ml/1.73m2/min was an independent risk factor for major complications. CONCLUSIONS: Perirenal hematoma needing blood transfusion is the most common major complication for children undergoing renal biopsy. Low eGFR is an independent risk factor for major complications. Early recognition and timely treatment should be delivered to children with renal function impairment accordingly.
Authors: G Ocak; M B Rookmaaker; A Algra; G J de Borst; P A Doevendans; L J Kappelle; M C Verhaar; F L Visseren Journal: J Thromb Haemost Date: 2017-12-20 Impact factor: 5.824
Authors: Luisa Santangelo; Giuseppe Stefano Netti; Paolo Giordano; Vincenza Carbone; Marida Martino; Diletta Domenica Torres; Michele Rossini; Anna Maria Di Palma; Loreto Gesualdo; Mario Giordano Journal: World J Pediatr Date: 2018-03-22 Impact factor: 2.764