Comparative analysis of blind vs real-time ultrasound-guided pediatric renal biopsies: A cross-sectional study |
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| Institution: | 1. Classified Specialist & Associate Professor (Pediatrics), Army Hospital (R&R), Delhi Cantt, India;2. Classified Specialist & Associate Professor (Pediatrics), INHS Kalyani, Vishakapatnam, India;3. Associate Professor (Pediatrics), AIIMS, Raebareli, UP, India;4. DCIDS (MED), Wing 7, West Block-3, RK Puram, New Delhi, India;1. Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India;2. Ex Professor & Head (Community Medicine), SMS Medical College, Jaipur, India;3. Professor & Head (Pediatric Dentistry), Rural Dental College, Loni, Maharashtra, India;4. Professor (Community Medicine), SMS Medical College, Jaipur, India;5. Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India;6. Resident, Department of Community Medicine, Armed Forces Medical College, Pune, India;1. Medical Cadet, Armed Forces Medical College, Pune, India;2. Associate Professor, Department of Dermatology, Armed Forces Medical College, Pune, India;3. Assistant Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India;4. Brig i/c Adm, Command Hospital (Central Command), Lucknow, India;1. Classified Specialist (Urology), Army Hospital (R&R), Delhi Cantt, India;2. Head of Department (Obst & Gynaec), Army Hospital (R&R), Delhi Cantt, India;3. Resident (Urology), Army Hospital (R&R), Delhi Cantt, India;4. Faculty (Obst & Gynaec), Army Hospital (R&R), Delhi Cantt, India;1. Professor (Radiology) & Interventional Radiologist, Command Hospital (Central Command), Lucknow, India;2. Assistant Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India;3. Associate Professor (Medicine) & Neurologist, Command Hospital (Central Command), Lucknow, India;4. Professor, Department of Radiology, Armed Forces Medical College, Pune, India;5. Professor (Medicine) & Neurologist, Armed Forces Clinic, New Delhi, India;1. Classified Specialist (Community Medicine), Indian Level 3 Hospital, MONUSCO, C/o 56, APO, India;2. Professor & Head, Department of Community Medicine, Armed Forces Medical College, Pune, India;3. Associate Professor, Department of Community Medicine, Armed Forces Medical College, Pune, India;4. DADH, HQ 11 Division, C/o 56 APO, India;5. Associate Professor, Department of Biochemistry, Armed Forces Medical College, Pune, India;6. ADH, HQ 11 Corps, C/o 56 APO, India;7. Classified Specialist (Microbiology), Base Hospital, Delhi Cantt, India |
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| Abstract: | BackgroundRenal biopsy has a definite role in the management of pediatric kidney diseases. Most centers have given up the earlier practice of performing blind biopsy using Tru-Cut needle and started doing real time ultrasound-guided renal biopsy with an automated spring-loaded gun, which has become standard of care in the last decade or so.MethodsWe performed a cross-sectional analysis of the pediatric biopsies conducted at our center over the years by both methods to evaluate whether ultrasound-guided renal biopsy with a disposable automated spring-loaded gun was superior to blind biopsy with a disposable needle of the same size in terms of reduction of complications and improving the yield. We also reviewed the indications and the histopathological diagnosis of pediatric renal biopsies at our center.ResultsA total of 45 native kidney biopsies were performed blind and 48 ultrasound-guided biopsies using the curvilinear probe (frequency 3-5 Hz) of GE Logiq P3 ultrasound machine with disposable spring-loaded automated guns. There was a significant increase in the yield of biopsy in terms of the number of glomeruli per pass. A significant increase in the mean number of glomeruli was noted when a biopsy was performed under ultrasound guidance (P < 0.0001). Gross hematuria was significantly reduced as compared to the earlier biopsies done blind i.e., without ultrasound (P ¼ 0.03). Nephrotic syndrome was the commonest indication for biopsy in our patients during both time periods studied. The most common histopathological diagnosis was MesPGN among the children who underwent kidney biopsy from 2005 to 2007, while Minimal Change Disease (MCD) and Focal Segmental Glomerulosclerosis (FSGS) were most frequently reported.ConclusionUltrasound guided kidney biopsies in pediatric age group have significant reduction in incidence of post gross hematuria and significant increase in the mean number of glomeruli per pass. |
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| Keywords: | Pediatric kidney biopsy Minimal change disease Focal segmental glomerular sclerosis Postbiopsy hematuria |
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