A pediatric nephrologist’s experience on real-time ultrasound-guided kidney biopsy

Abstract

Aim: Kidney biopsy is crucial in management of renal diseases. Biopsies in children have added difficulties. The aim of this study is to investigate our 5-year experience of real-time ultrasound (USG)-guided percutaneous renal biopsy (PRB). Methods: Institutional database of children who underwent PRB in a tertiary hospital between January 2015 and March 2020 were evaluated retrospectively. A single pediatric nephrologist performed all the biopsies using an automated spring-loaded biopsy gun under real-time USG guidance. Results: Thirty-two biopsies were performed in 17 males (53.1%) and 15 females (46.9%), and the median age of the children was 14.5 years. The most common indication for biopsy was nephrotic syndrome in 13 /32 children (40.6%). Median number of glomeruli obtained from biopsy specimens was 18 (min-max=7-54 glomeruli). A diagnosis was achieved in all cases (100%) by a histopathologist. The only complication observed in a 16-year-old boy was a self-limited gross hematuria (3.1%) episode with subcapsular hematoma. Conclusion: Real-time USG-guided PRB with an automated biopsy gun is an effective and safe technique, providing superior yield when performed by a pediatric nephrologist. Performing kidney biopsy is an essential tool in a nephrologist’s workshop.

Keywords

• kidney biopsy
• real-time USG guidance
• biopsy gun
• children
• paediatric nephrologist

Bir çocuk nefroloğunun eş-zamanlı ultrasonografi eşliğinde böbrek biyopsisi deneyimi

Öz

Amaç: Böbrek biyopsisinin böbrek hastalıklarının yönetiminde oldukça önemli bir yeri vardır. Özellikle çocuklarda yapılan biyopsiler ek zorluklar gösterir. Bu çalışmanın amacı, çocuklarda uygulamış olduğumuz beş yıllık ultrasonografi eşliğinde perkutan böbrek biyopsisi (PRB) deneyimimizi değerlendirmektir. Yöntemler: Ocak 2015- Mart 2020 arasında bir üçüncü basamak hastanesinde PRB uygulanan çocukların hastane kayıtları geriye dönük olarak irdelenmiştir. Tüm biyopsiler, eş zamanlı USG altında tek bir çocuk nefroloğu tarafından otomatik biyopsi tabancası kullanılarak uygulanmıştır. Bulgular: Medyan yaşı 14,5 yaş olmak üzere; 17 erkek (%53,1) ve 15 kız çocuğuna (%46,9) 32 böbrek biyopsisi uygulandı. En sık biyopsi endikasyonu, çocukların 13/32’sinde (%40,6) nefrotik sendrom idi. Biyopsi örneklerinden alınan medyan glomerül sayısı 18 (min-max=7-54 glomerül) idi. Histopatolog tarafından tüm olgularda (%100) tanı konulabildi. Gözlenen tek komplikasyon, 16 yaşındaki bir erkek çocuğunda subkapsüler hematomla birlikte kendiliğinden düzelen gross hematüri süreci idi (%3,1). Sonuç: Çocuklarda; PRB Bir çocuk nefroloğu tarafından otomatik biyopsi tabancası kullanılarak, eş-zamanlı USG altında yapıldığında, yeterince fazla örneğin alınmasını sağlayan, etkili ve güvenli bir tekniktir. Böbrek biyopsisi, bir nefroloğun çalışma sorumluluğunda yapması gereken önemli bir uygulamadır.

Anahtar Kelimeler

• Böbrek biyopsisi
• Çocuklar
• Eş-zamanlı ultrasonografi
• Biyopsi tabancası

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