Risk factors for complications of percutaneous ultrasound-guided renal biopsy in children

  • Jhao-Jhuang Ding
  • Shih-Hua Lin
  • Jing-Long Huang
  • Tai-Wei Wu
  • Shao-Hsuan Hsia
  • Jainn-Jim Lin
  • Yu-Ching Chou
  • Min-Hua TsengEmail author
Original Article



Percutaneous ultrasound-guided renal biopsy (PURB) is an invasive but essential procedure in establishing the histologic diagnosis of pediatric renal diseases. Large studies which describe PURB complications and its contributory risk factors are scarce in the pediatric literature.


Patients who underwent real-time PURB from September 2011 to August 2017 were retrospectively reviewed. Data pertaining to clinical characteristics, histologic diagnosis and biopsy-related complications were collected. In addition, the risk factors for complications were also analyzed.


Overall, 183 patients (109 females) were enrolled and 201 biopsies were obtained. The mean age was 14.4 ± 13.7 years. Over 98% of the biopsies were considered adequate in quality. The major complications were perirenal hematoma requiring blood transfusion (4 cases, 2.0%), followed by perirenal abscess (1 case, 0.5%) and arteriovenous fistula (1 case, 0.5%). All patients recovered without sequelae after treatment. Hypertension, low estimated glomerular filtration rate (eGFR) and anemia were more common in patients with complication than in those without. Further logistic regression model analysis demonstrated that eGFR <30 ml/1.73m2/min was an independent risk factor for major complications.


Perirenal hematoma needing blood transfusion is the most common major complication for children undergoing renal biopsy. Low eGFR is an independent risk factor for major complications. Early recognition and timely treatment should be delivered to children with renal function impairment accordingly.


Percutaneous renal biopsy Real-time ultrasound guidance Complication Perirenal hematoma Arteriovenous fistula Pediatric 



This study was supported in part by research fund of Chang Gung Memorial Hospital (CMRPG3H0361, CMRPG3H0911, CMRPG3I0021), the Ministry of Science and Technology (MOST 106-2314-B-182A-123-MY3), and the Research Fund of Tri-Service General Hospital (TSGH-C106-110, TSGH-C108-132). We thank Prof. Martin Konrad for critical review of the revised manuscript and for the critical help with statistical analysis.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© IPNA 2019

Authors and Affiliations

  • Jhao-Jhuang Ding
    • 1
    • 2
  • Shih-Hua Lin
    • 3
  • Jing-Long Huang
    • 4
  • Tai-Wei Wu
    • 5
  • Shao-Hsuan Hsia
    • 6
  • Jainn-Jim Lin
    • 6
  • Yu-Ching Chou
    • 7
    • 8
  • Min-Hua Tseng
    • 1
    Email author
  1. 1.Division of Nephrology, Department of PediatricsChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  2. 2.Department of Pediatrics, Tri-Service General HospitalNational Defense Medical CenterTaipeiTaiwan
  3. 3.Department of Nephrology, Tri-Service General HospitalNational Defense Medical CenterTaipeiTaiwan
  4. 4.Division of Allergy, Asthma and Rheumatology, Department of PediatricsChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  5. 5.Fetal and Neonatal Institute, Division of Neonatology Children’s Hospital Los Angeles, Department of Pediatrics, Keck School of MedicineUniversity of Southern CaliforniaLos AngelesUSA
  6. 6.Division of Pediatric Critical Care Medicine, Department of PediatricsChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan
  7. 7.School of Public HealthNational Defense Medical CenterTaipeiTaiwan
  8. 8.Division of Nephrology, Department of MedicineTri-Service General HospitalTaipeiTaiwan

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