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Indications and results of renal biopsy in children: a 36-year experience

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Abstract

Background

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.

Methods

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.

Results

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%).

Conclusions

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.

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References

  1. Warady BA, Chadha V. Chronic kidney disease in children: the global perspective. Pediatr Nephrol. 2007;22:1999–2009.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Korbet SM. Percutaneus renal biopsy. Semin Nephrol. 2002;22:254–67.

    Article  PubMed  Google Scholar 

  3. Schena FP. Survey of the Italian Registry of Renal Biopsies. Frequency of the renal diseases for 7 consecutive years. The Italian Group of Renal Immunopathology. Nephrol Dial Transpl. 1997;12:418–26.

  4. Gesualdo L, Di Palma AM, Morrone LF, Strippoli GF, Schena FP, Italian Immunopathology Group, Italian Society of Nephrology. The Italian experience of the national registry of renal biopsies. Kidney Int. 2004;66:890–4.

    Article  PubMed  Google Scholar 

  5. Sugiyama H, Yokoyama H, Sato H, Saito T, Kohda Y, Nishi S, et al. Japan renal biopsy registry and japan kidney disease registry: committee report for 2009 and 2010. Clin Exp Nephrol. 2013;17:155–73.

    Article  PubMed  Google Scholar 

  6. Rychlík I, Jancová E, Tesar V, Kolsky A, Lácha J, Stejskal J, et al. The Czech registry of renal biopsies. Occurrence of renal diseases in the years 1994–2000. Nephrol Dial Transplant. 2004;19:3040–9.

    Article  PubMed  Google Scholar 

  7. Zaza G, Bernich P, Lupo A, "Triveneto" Register of Renal Biopsies (TVRRB). Renal biopsy in chronic kidney disease: lessons from a large Italian registry. Am J Nephrol. 2013;37:255–63.

    Article  PubMed  Google Scholar 

  8. Yuen LK, Lai WM, Lau SC, Tong PC, Tse KC, Chiu MC. Ten-year review of disease pattern from percutaneous renal biopsy: an experience from a paediatric tertiary renal centre in Hong Kong. Hong Kong Med J. 2008;14:348–55.

    CAS  PubMed  Google Scholar 

  9. Coppo R, Gianoglio B, Porcellini MG, Maringhini S. Frequency of renal diseases and clinical indications for renal biopsy in children (report of the Italian National Registry of Renal Biopsies in Children). Group of Renal Immunopathology of the Italian Society of Pediatric Nephrology and Group of Renal Immunopathology of the Italian Society of Nephrology. Nephrol Dial Transplant. 1998;13:293–7.

    Article  CAS  PubMed  Google Scholar 

  10. Demircin G, Delibaş A, Bek K, Erdoğan O, Bülbül M, Baysun S, et al. A one-center experience with pediatric percutaneous renal biopsy and histopathology in Ankara, Turkey. Int Urol Nephrol. 2009;41:933–9.

    Article  PubMed  Google Scholar 

  11. Lanewala A, Mubarak M, Akhter F, Aziz S, Bhatti S, Kazi JI. Pattern of pediatric renal disease observed in native renal biopsies in Pakistan. J Nephrol. 2009;22:739–46.

    PubMed  Google Scholar 

  12. Piotto GH, Moraes MC, Malheiros DM, Saldanha LB, Koch VH. Percutaneous ultrasound-guided renal biopsy in children—safety, efficacy, indications and renal pathology findings: 14-year Brazilian university hospital experience. Clin Nephrol. 2008;69:417–24.

    Article  CAS  PubMed  Google Scholar 

  13. Paripović D, Kostić M, Kruščić D, Spasojević B, Lomić G, Marković-Lipkovski J, et al. Indications and results of renal biopsy in children: a 10-year review from a single center in Serbia. J Nephrol. 2012;25:1054–9.

    Article  PubMed  Google Scholar 

  14. Bohlin AB, Edström S, Almgren B, Jaremko G, Jorulf H. Renal biopsy in children: indications, technique and efficacy in 119 consecutive cases. Pediatr Nephrol. 1995;9:201–3.

    Article  CAS  PubMed  Google Scholar 

  15. White RH, Poole C. Day care renal biopsy. Pediatr Nephrol. 1996;10:408–11.

    CAS  PubMed  Google Scholar 

  16. Madani A, Fahimi D, Esfehani ST, Mohsseni P, Atayee N, Ahmadi M, et al. Glomerular diseases in Iranian children: clinico-pathological correlations. Pediatr Nephrol. 2003;18:925–8.

    Article  PubMed  Google Scholar 

  17. Bogdanović R, Ognjenović M, Cvorić A, Nikolić V. Percutaneous biopsy of the kidney in children: indications, results, and complications. Srp Arh Celok Lek. 1990;118:243–50 (in Serbian).

    PubMed  Google Scholar 

  18. Batinić D, Sćukanec-Spoljar M, Milosević D, Subat-Dezulović M, Saraga M, Delmis J, et al. Clinical and histopathological characteristics of biopsy-proven renal diseases in Croatia. Acta Med Croatica. 2007;61:361–4 (in Croatian).

    PubMed  Google Scholar 

  19. 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.

    CAS  PubMed  PubMed Central  Google Scholar 

  20. Abdelraheem MB, Ali el-TM, Mohamed RM, Hassan EG, Abdalla OA, Mekki SO, et al. Pattern of glomerular diseases in Sudanese children: a clinico-pathological study. Saudi J Kidney Dis Transpl. 2010;21:778–83.

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

    Article  PubMed  Google Scholar 

  22. Fogo A. Renal pathology. In: Avner E, editor. Pediatric nephrology. 6th ed. Berlin: Springer; 2009. p. 565–98.

    Chapter  Google Scholar 

  23. International Study of Kidney Disease in Children. Ten years of activity: a report for the international study of kidney disease in children. In: Batsford SR, editor. Glomerulonephritis. New York: Wiley; 1977. p. 201–9.

    Google Scholar 

  24. Nephrotic syndrome in children: prediction of histopathology from clinical and laboratory characteristics at time of diagnosis. A report of the International Study of Kidney Disease in Children. Kidney Int. 1978;13:159–65.

  25. White RH, Glasgow EF, Mills RJ. Clinicopathological study of nephrotic syndrome in childhood. Lancet. 1970;1:1353–9.

    Article  CAS  PubMed  Google Scholar 

  26. Tune BM, Mendoza SA. Treatment of the idiopathic nephrotic syndrome: regimens and outcomes in children and adults. J Am Soc Nephrol. 1997;8:824–32.

    CAS  PubMed  Google Scholar 

  27. Inaba A, Hamasaki Y, Ishikura K, Hamada R, Sakai T, Hataya H, et al. Long-term outcome of idiopathic steroid-resistant nephrotic syndrome in children. Pediatr Nephrol. 2016;31:425–34.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank Dr. Tommaso De Palo, Dr. Giovanni Messina and Dr. Flora Puteo who critically revised the present manuscript.

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Authors and Affiliations

  1. Unit of Pediatric Nephrology and Dialysis, Pediatric Hospital “Giovanni XXIII”, Bari, Italy

    Luisa Santangelo, Paolo Giordano, Vincenza Carbone, Marida Martino, Diletta Domenica Torres, Loreto Gesualdo & Mario Giordano

  2. Clinical Pathology, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy

    Giuseppe Stefano Netti

  3. Unit of Nephrology, Dialysis and Transplantation, Department of Emergency and Organ, Transplantation, University “Aldo Moro”, Bari, Italy

    Marida Martino, Michele Rossini, Anna Maria Di Palma & Loreto Gesualdo

Authors
  1. Luisa Santangelo
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  2. Giuseppe Stefano Netti
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  3. Paolo Giordano
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  4. Vincenza Carbone
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  5. Marida Martino
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  6. Diletta Domenica Torres
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  7. Michele Rossini
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  8. Anna Maria Di Palma
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  9. Loreto Gesualdo
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  10. Mario Giordano
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Contributions

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.

Corresponding author

Correspondence to Mario Giordano.

Ethics declarations

Ethical approval

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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Santangelo, L., Netti, G.S., Giordano, P. et al. Indications and results of renal biopsy in children: a 36-year experience. World J Pediatr 14, 127–133 (2018). https://doi.org/10.1007/s12519-018-0147-5

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  • DOI: https://doi.org/10.1007/s12519-018-0147-5

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