Real time ultrasound guided pediatric percutaneous renal biopsy: the traditional method versus angled tangential approach.

AIM The aim of the present study was to compare the success and complication rates of pediatric renal biopsy procedures between the angled tangential approach and the traditional approach. METHODS From 2004 to 2009 we prospectively enrolled pediatric patients who had undergone real time ultrasound guided renal biopsy with angled tangential approach. For comparison, we retrospectively reviewed pediatric patients who had undergone traditional renal biopsy between 2002 and 2004. Adequacy of renal tissue histopathological samples and the complication rates were compared between groups. RESULTS One hundred twenty-eight patients underwent traditional renal biopsy (Group A) while 166 patients underwent biopsy performed with angled tangential approach (Group B).The rate of inadequate material was higher in Group A compared to Group B (6.3% vs. 0.6%, p = 0.006). In four cases (three in Group A and one in Group B) renal biopsies revealed normal renal tissue. While a major complication (hemoperitoneum requiring transfusion) occurred in one case in Group A, no major complications were seen in Group B. CONCLUSION Compared with the traditional technique, the angled tangential approach resulted in a higher adequate material rate and lower complication rate.These findings indicate that angled tangential approach could be considered for pediatric percutaneous renal biopsies.

[1]  Raul N Uppot,et al.  Imaging-guided percutaneous renal biopsy: rationale and approach. , 2010, AJR. American journal of roentgenology.

[2]  E. Mayo US-guided renal transplant biopsy:efficacy of a cortical tangential approach , 2010 .

[3]  A. Melk CHAPTER 3 – Tools for Renal Tissue Analysis , 2008 .

[4]  S. Sampaio,et al.  Renal diseases: a 27-year renal biopsy study. , 2006, Journal of nephrology.

[5]  Zhi-Hong Liu,et al.  Epidemiologic data of renal diseases from a single unit in China: analysis based on 13,519 renal biopsies. , 2004, Kidney international.

[6]  W. Whittier,et al.  Timing of complications in percutaneous renal biopsy. , 2004, Journal of the American Society of Nephrology : JASN.

[7]  唐政,et al.  Pathological demography of native patients in a nephrology center in China , 2003 .

[8]  P. Parichatikanond,et al.  Percutaneous renal biopsy in children. , 2002, Journal of the Medical Association of Thailand = Chotmaihet thangphaet.

[9]  N. Disma,et al.  Two doses of oral ketamine, given with midazolam, for premedication in children. , 2002, Minerva anestesiologica.

[10]  T. Chan,et al.  Free-hand, ultrasound-guided percutaneous renal biopsy: experience from a single operator. , 2002, European journal of radiology.

[11]  J. B. Ponikvar,et al.  Real‐time ultrasound‐guided renal biopsy with a biopsy gun in children: safety and efficacy , 2001, Acta paediatrica.

[12]  A. Fogo Atlas of Renal Pathology , 1999 .

[13]  J. Laméris Renal anatomy applied to urology, endourology, and interventional radiology , 1993 .