Indications and results of renal biopsy in children: a 36-year experience
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This study was conducted to investigate retrospectively the indications for renal biopsy (RB) in native kidneys and to analyze pathological findings in a single tertiary pediatric hospital in Southern Italy for the last 36 years.
All patients who underwent RB at our hospital from 1979 to 2014 were included. All renal tissue specimens were studied under light and immunofluorescent microscopy, while electron microscopy was performed only for specific clinical indications.
The study group included 213 patients (female 43.2%) who underwent 225 percutaneous native kidney biopsies. Median age was 10.4 years (range 0.6–24 years). The most frequent indication for RB was nephrotic syndrome (44.4%), followed by proteinuria (27.6%), asymptomatic hematuria (17.3%) and acute kidney injury (9.8%). Gross hematuria appeared after biopsy in less than 5% of the patients, but none of them needed blood transfusion. Adequate renal tissue sample was obtained in 95.5% of the renal biopsies. Primary glomerulonephritis (GN) was the most common finding (61.4%), followed by secondary GN (21.4%), tubulointerstitial diseases (3.7%) and hereditary nephropathy (2.8%), while in 10.7% of the cases, normal renal tissues were found. According to histopathological diagnosis, the most common causes of primary GN were IgA nephropathy (20.9%), followed by minimal change disease (18.1%) and focal segmental glomerulosclerosis (11.6%).
The epidemiology of glomerular disease in our single-center cohort is similar to that shown in other national and international reports. Moreover, our study shows that percutaneous ultrasound-guided RB is a safe, reliable and effective technique in children.
KeywordsEpidemiology Glomerular diseases Nephropathy Pediatric patients Renal biopsy
The authors thank Dr. Tommaso De Palo, Dr. Giovanni Messina and Dr. Flora Puteo who critically revised the present manuscript.
LS and GSN designed the study, analyzed data and drafted the manuscript. They contributed equally to this work. PG, VC, MM and DDT collected the clinical data. MR and AMDP collected the histological data. LG helped to draft the manuscript. MG participated in design and coordination of study and gave the final approval.
Compliance with ethical standards
A retrospective study based on registry data was carried out and no ethics approval was required. Nevertheless all the patients signed a written informed consent to collect their clinical and histologic data at time of renal biopsy.
Conflict of interest
No financial or non-financial benefits have been received or will be received from any party related directly or indirectly to the subject of this article.
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