Evaluation of Percutaneous Renal Biopsy Results in Children: An Eleven-Year Survey

Percutaneous renal biopsy is an important method to establish a pathological diagnosis, to monitor the disease progression and to assess the response to therapy in children. The aim of this retrospective study was to analyse the renal biopsy results and to review the indications for children. Total 458 renal biopsies of 374 patients [(189 boys, 185 girls) aged 1 month-15 years (average: 7.4±4.1 years)] were performed by percutaneous technique guided by ultrasonography in our institution during the period between January 1994 and December 2004. Biopsy indications and diagnoses as well as management and outcome of patients were determined by investigation of clinic records. Eighty-four repeat biopsies were performed during the observation period (second biopsy in 68, third biopsy in 15 patients and fourth in 1 patient). The mean number of glomeruli obtained was 28.22±21.66. The most common renal biopsy indication was nephrotic syndrome in 175 (46.8%) cases. Other indications were renal involvement of systemic diseases (16.8%), nephritic syndrome (12.1%), isolated hematuria (10.9%), acute renal failure (4.8%), chronic renal failure (3.5%), isolated non-nephrotic proteinuria (1.4%) and others (3.7%). The most frequent nephropathy was focal segmental glomerulosclerosis (19.8%). Other diagnostic entities were minimal change disease (14.4%), membranoproliferative glomerulonephritis (11.8%), IgA nephropathy (11.2%), diffuse proliferative glomerulonephritis (7%), lupus nephritis (4.8%), mesangial proliferative glomerulonephritis (3.5%), amyloidosis (1.6%), membranous glomerulonephritis (1.6%), crescentic glomerulonephritis (1.6%), normal (7.5%) and others (10.2%). Diagnostic material was not obtained in 19 (5 %) renal biopsies. No complications such as loss of the kidney, serious infection or hemorrhage of clinical importance were observed. Percutaneous renal biopsy is a useful diagnostic method and can be used as a therapeutic guideline in children with renal disease.