ESPN 53rd Annual Meeting

ESPN 2021


 
Safety and complications of kidney biopsies in children: a single centre study from Sweden
MIA DURSUN 1 PER BRANDSTRÖM 1 SVERKER HANSSON 1

1- INSTITUTE OF CLINICAL SCIENCES, SAHLGRENSKA ACADEMY, UNIVERSITY OF GOTHENBURG, SWEDEN
 
Introduction:

Percutaneous kidney biopsy is considered a safe procedure in the diagnosis and management of paediatric kidney disease. We aimed to study complications to percutaneous kidney biopsies made in children in our centre and to target potential risk factors to the procedure.

Material and methods:

We retrospectively studied kidney biopsies performed during a five-year period in the Swedish regional centre of Queen Silvia Children´s Hospital. Our study included both native and transplanted kidneys, with exclusion of oncological biopsies. All biopsies were performed by a paediatric radiologist under general anaesthesia using ultrasound-guidance. Most of the elective biopsies followed a protocol enabling discharge after six to seven hours of observation. Complications were divided into minor, moderate and major events, where minor complications were classified as events not in need of further investigation nor intervention.

Results:

232 biopsies were performed in 198 individuals, 116 (59%) boys and 82 (41%) girls. The median age was 10.8 (1.4–18.4) years. Nephrotic proteinuria or minimal change disease was the most common indication, followed by non-nephrotic proteinuria or haematuria and investigation of kidney transplants. One major complication with the need of blood transfusion occurred. The complication was identified as a large renal hematoma during the procedure. We found the most common complications being minor complications, involving minor reduction of haemoglobin, renal hematomas and transient macroscopic haematuria. Identification of 75% of complications was made by <6 hours and 95% by <12 hours. Increased number of needle passes and low diastolic blood pressure was significantly associated with moderate to major complications.

Conclusions:

Kidney biopsy in children is a low-risk procedure. The number of needle passes and low diastolic blood pressure were associated with the risk for more serious complications in children.