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



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


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.


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Tondel C, Vikse BE, Bostad L, Svarstad E. Safety and complications of percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988-2010. Clin J Am Soc Nephrol. 2012;7:1591-7.

Korbet SM. Nephrology and the Percutaneous Renal Biopsy: A Procedure in Jeopardy of Being Lost Along the Way. Clin J Am Soc Nephrol. 2012;7:1545–7.

Poster RB, Jones DB, Spirt BA. Percutaneous Pediatric Renal Biopsy: Use of the Biopsy Gun. Radiology. 1990;176:725-7.

Hogan JJ, Mocanu M, Berns JS. The native kidney biopsy: Update and evidence of best practice Clin J Am Soc Nephrol. 2016;11:354-62.

Golay V, Roychowdhury A. The percutaneous native kidney biopsy: a nephrologist’s perspective. OA Nephrology. 2013;May 27;1:8.

Franke M, Kramarczyk A, Taylan C, Maintz D, Hoppe B, Koerber F. Ultrasound-Guided Percutaneous Renal Biopsy in 295 Children and Adolescents: Role of Ultrasound and Analysis of Complications. PLoS ONE. 2014;9(12): e114737. doi:10.1371/journal.pone.0114737.

Hussain F, Mallik M, Marks SD, Watson AR, British Association of Paediatric Nephrology. On behalf of the British Association of Paediatric Nephrology. Renal biopsies in children: current practice and audit of outcomes. Nephrol Dial Transplant. 2010;25:485–9.

Hussain F, Watson A, Hayes J, Evans J. Standards for renal biopsies; comparison of inpatient and day care procedures. Pediatr Nephrol. 2003;18:53-6.

Gupta S, Wallace MJ, Cardella JF, Kundu S, Miller DL, Rose SC. Quality improvement guidelines for percutaneous needle biopsy. J Vasc Interv Radiol. 2003; 14(Suppl):S227-S30.

Hama T, Nakanishi K , Shima Y, Mukaiyama H, Togawa H, Tanaka R, et al. Renal biopsy criterion in children with asymptomatic constant isolated proteinuria . Nephrol Dial Transplant. 2012;27:3186–90.

Gattineni J. Highlights for the Management of a Child with Proteinuria and Hematuria. International Journal of Pediatrics. 2012;768142:1-7.

Schwartz GJ and Work DF. Measurement and estimation of GFR in children and adolescents. J Am Soc Nephrol. 2009;4:1832-43.

Flynn JT, Kaelber DC, Baker-Smith CM, Blowey D, Carroll AE, Daniels SR et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics. 2017;140(3):e20171904.

Racusen LC, Solez K, Colvin RB, Bonsib SM, Castro MC, Cavallo T, et al. The Banff 97 working classification of renal allograft pathology. Kidney International.1999;55:713-23.

Fogo AB. Approach to renal biopsy. AJKD. 2003;Vol 42: No4 (October).

Esposito V, Mazzon G, Baiardi P, Toreggiani M, Semeraro L, Catucci D et al. Safety and adequacy of percutaneous kidney biopsy performed by nephrology trainees. BMC Nephrology. 2018;19:14.

Lee SA, Kim MS, Kim SC, Lee DY. Clinical and Pathological Findings of Renal Biopsy in Children: Outcomes from a Single Center Over 27 Years Child Kidney Dis. 2017;21:8-14.

Printza N, Bosdou J, Pantzaki A, Badouraki M, Kollios K, Ghogha Ch, et al. Percutaneous ultrasound-guided renal biopsy in children: a single centre experience. HIPPOKRATIA. 2011;15;258-61.

Whittier WL, Gashti C, Saltzberg S, Korbet S. Comparison of native and transplant kidney biopsies: diagnostic yield and complications. Clin Kidney J. 2018;11: 616–22.

Pongsittisak W, Wutilertcharoenwong N, Ngamvichchukorn T, Kurathong S, Chavanisakun C, Teepprasan T, et al. The efficacy of blind versus real-time ultrasound-guided percutaneous renal biopsy in developing country. SAGE Open Medicine. 2019;7:1-7.

Turner MW, Hutchinson TA, Barre PE, Jothy S. A prospective study on the impact of renal biopsy in clinical management. Clin Nephrol. 1986;26:217-21.

Korbet SM, Gashti CN, Evans JK, Whittier WL. Risk of percutaneous renal biopsy of native kidneys in the evaluation of acute kidney injury. Clinical Kidney Journal. 2018;11;610–5.

Sethi I, Brier M, Dwyer A. Predicting post renal biopsy complications Semin Dial. 2013;26:633-5.

Korbet SM. Percutaneous renal biopsy. Semin Nephrol. 2002;22:254-67.

Lees JS, McQuarrie EP, Mackinnon B. Renal biopsy: it is time for pragmatism and consensus. Clinical kidney Journal. 2018;11:605-9.

Nicholson ML, Wheatley TJ, Doughman TM, White SA, Morgan JD, Veitch PS, et al. A prospective randomized trial of three different needle for renal transplant biopsy. Kidney Int. 2000;58:390-5.

Gupta A, Smith JC, Hayes W, Deal JE, Gilbert RD, Inward C, et al. Positive trends in paediatric renal biopsy service provision in the UK: a national survey and re-audit of paediatric renal biopsy practice. Pediatr Nephrol. 2016;31:613-21.






Research Article

How to Cite

Simsek B. A pediatric nephrologist’s experience on real-time ultrasound-guided kidney biopsy. J Surg Med [Internet]. 2020 Dec. 1 [cited 2022 Aug. 18];4(12):1177-81. Available from: https://jsurgmed.com/article/view/803699