Efficacy Of Percutaneous Renal Biopsy Research Articles

Histopathological patterns of renal diseases in egyptian children: A single-center experience.

The present cross-sectional, retrospective study was aimed to determine the histopathological spectrum of renal diseases in Egyptian children and to evaluate the indications, safety, and efficacy of percutaneous renal biopsy (PRB) in a large tertiary center in Egypt. PRBs performed at the Department of Pediatrics, Tanta University Hospital over a period of nine years (from January 2007 to December 2015) were included. Light microscopic (LM) examination was performed in all cases while immunofluorescence and electron microscopic examination were performed in selected cases. Two hundred and thirty renal biopsies were performed during the study duration. Nine biopsies were excluded from the study due to insufficient sample (<7 glomeruli per specimen) giving a PRB efficacy rate of 96.1%. Results of 221 renal biopsies performed on 210 patients from native kidneys were described. Ninety-seven patients were male (46.19%) and 113 were female (53.81%) with age ranging from three months to 18 years (mean 10.51 ± 3.81 years). The main indications of renal biopsy were nephrotic syndrome (NS) (43.89%), lupus nephritis (23.53%), and recurrent or persistent hematuria (10.41%). The most common finding on LM examination of renal biopsies from children with NS was minimal change disease (22.17%). Secondary nephropathies were mostly due to lupus (23.53%). IgA nephropathy was found in eight patients (3.62%). Local pain at the site of biopsy was the most common minor complication seen postbiopsy (60.58%). Transient gross hematuria was seen in 13 patients (5.88%) without urinary retention. Major complications that required surgical intervention or blood transfusion did not occur. NS was the main indication and minimal change disease was the most common histological finding of renal biopsies from Egyptian children. Complications and efficacy of renal biopsy procedure were comparable to that reported from developed countries.

Clinical efficacy of percutaneous renal biopsy under the guide of B-ultrasound in treatment of children with upper urinary tract calculi

Objectives To investigate the clinical efficacy and safety of percutaneous renal biopsy under the guide of B-ultrasound in treatment of children with upper urinary tract calculi. Methods The clinical data of 80 patients with upper urinary tract calculi in 82 cases were retrospectively analyzed. The average age was (33.1±17.3) months, the average size was (1.47±0.43)cm. Left side(34 cases), right side(43 cases), bilateral(2 cases) (no urine, renal dysfunction), 46 cases of single stone, 34 cases of multiple stones, 64 cases of renal pelvis, 5 cases of ureteral calculi, 6 cases of renal calculi combined with ureteral calculi, 4 cases with renal calculi, 1 cases of patients with renal pelvis were found. First, children with upper urinary tract calculi, prone position, B-ultrasound guided puncture target calyx, were indwelled 4-5F ureteral catheter with ureteroscope .During the operation, WOLF 8/9.8F ureteroscope and 16F peel-away were used in ballast lithotripsy. Results 82 cases were treated with operation, 78 cases with stone free at first time, 4 cases of stone free at second time, 4 cases of residual stones were found. Stone-free rate at third day after operation was 95.2%. Operation time was 15 ~ 90 min, average time was (33±21.7)min. HGB decreased (9.8 ± 7.8) g/L, and the change of HCT was (0.0375 ± 0.0367)%. The average hospitalization time was (6±1.6)d, 1 cases with pleural effusion, 15 cases with fever, no serious complications occurred. There was no recurrence of st- ones within 1 month after operation. Conclusions Percutaneous renal biopsy under the guide of B-ultrasound is safe and effective in the treatment of pediatric renal and ureteral calculi. Key words: Urinary Calculi; Ureteroscopes; Punctures

Safety and efficacy of percutaneous renal biopsy by physicians-in-training in an academic teaching setting.

The safety and efficacy of percutaneous renal biopsy (PKB) are relatively little studied in a training setting. We sought to review our recent experience with bedside PKB in our training program. We performed a retrospective cohort review of our consecutive 2.5-year renal biopsy experience (May 2007-November 2009) at the University of Mississippi Nephrology Fellowship. All of the biopsies were performed exclusively by renal fellows using real-time ultrasound (US) visualization within the framework of a structured US-PKB training course. A total of 64 patients underwent PKB during the index period; 50 (78.1%) of these procedures were performed on native kidneys. Participant age was 39.8 ± 13.7 years, blood pressures measured 140.1/85.3 ± 21.5/14.9 mm Hg, serum creatinine was 3.05 ± 3.15 mg/dL, and median random urine protein:creatinine ratio was 2.38 (25%-75% interquartile range 0.49-7.32). The biopsied kidneys measured 11.8 (±1.6) cm. We recovered 18.8 ± 11.5 glomeruli per procedure; two biopsies were unsuccessful. Focal glomerular sclerosis and lupus nephritis (22% and 25%, respectively) predominated among the specimens. Only three specimens returned with no diagnostic changes. There was a close correlation between preceding history and recovered diagnoses of diabetic changes and lupus nephritis (r 0.605 and 0.842; P < 0.0001 for both). Initial hemoglobin of 10.8 ± 1.8 g/dL dropped to 10.2 (1.9) g/dL after the procedure (P < 0.0001). Five (7.8%) patients needed transfusion; one patient experienced persistent urine leakage; however, none of the patients needed surgical or radiological intervention or died. In the setting of a well-structured training environment, US-guided PKB is a reasonably safe and valuable component of renal fellowship training.

Commentary on "Safety and efficacy of percutaneous renal biopsy by physicians-in-training in an academic teaching setting".

Commentary on "Safety and efficacy of percutaneous renal biopsy by physicians-in-training in an academic teaching setting".

Percutaneous ultrasound-guided renal biopsy in children: The need for renal biopsy in pediatric patients with persistent asymptomatic microscopic hematuria.

Percutaneous renal biopsy (PRB) is essential for the diagnosis, prognosis, and management of children with unknown kidney disease. In this study, the safety and efficacy of PRB is investigated, and also the common etiologies of childhood kidney disease, based on histological findings. In addition, we explored the role of PRBs in the diagnosis of children who presented with persistent asymptomatic hematuria. By chart review, from July 2005 to July 2009, a total of 99 PRBs were performed on 91 children (43 girls and 48 boys; mean age, 10.9 ± 4.4 years) under ultrasound (US) guidance, by a doctor, using an automated 18-gauge biopsy needle following the same protocol, at a medical center in northern Taiwan. The accuracy of the histological diagnosis was excellent. The most common post-biopsy complications were perirenal hematoma (11.1%) and asymptomatic gross hematuria (3.0%), respectively. Nevertheless, these complications resolved spontaneously, and none had major bleeding episodes. Histological results showed that lupus nephritis, minimal change disease, and IgA nephropathy (IgAN) could be the current leading causes of childhood kidney diseases in Taiwan. Automated ultrasound (US)-guided PRB is a safe and reliable method of assessing childhood renal disease. A recent study shows that the presence of persistent asymptomatic isolated microhematuria in adolescents is a predictive marker of future end-stage renal disease. Hence, the emphasis of renal biopsy on children with persistent asymptomatic hematuria is beneficial for the early diagnosis of IgAN or other glomerulonephritis (GN), which tends toward progressive kidney disease in adulthood without prompt therapeutic intervention.

255 Safety and Efficacy of Percutaneous Renal Biopsy By Physician-In-Training in an Academic Teaching Setting

255 Safety and Efficacy of Percutaneous Renal Biopsy By Physician-In-Training in an Academic Teaching Setting