979 Inpatient Versus Outpatient Settings for Performing Percutaneous Renal Biopsies

Abstract

Background: Renal biopsy is the gold standard for a definate diagnosis of a variety of renal diseases. Adequate patient preparation and evaluation are mandatory. Though invasive, renal biopsy is generally considered a safe procedure in paediatric patients.

Patients and Methods: We have retrospectively reviewed the charts of 88 consecutive patients under the age of 15 years who have undergone percutaneous renal biopsies. After adequate preparation Biopsies were performed blindly under aseptic conditions. All biopsies were performed using an automated spring-loaded core biopsy needle. In most cases, the lower pole was targeted in native kidney biopsies, and the upper of pole in transplanted kidneys.

Results: Samples from 43 native kidneys (49%), and 45from transplanted kidneys (51%). There were no deaths, and none of the patients with haemorrhage required nephrectomy. All complications were diagnosed within the initial 4- to 6-hour observation period following the procedure. There were only 2 (4%) and 4 (9%) inadequate samples in the inpatient and outpatient groups, respectively.

Discussion: The incidence of serious complications of percutaneous renal biopsy in the literature is rare. Our overall complication rates of 8.8% and 13.9% for the inpatient and outpatient procedures, respectively. Our overall rate of complications compares favourably with the rate in literatures.

Conclusion: This is a further evidence that it is safe to perform percutaneous renal biopsy in children in an outpatient setup after careful screening and that observation for 4 to 6 hours after the procedure is adequate to detect complications. However, this should only be undertaken where backup services are readily available.

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