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Positive trends in paediatric renal biopsy service provision in the UK: a national survey and re-audit of paediatric renal biopsy practice

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Abstract

Background

Paediatric renal biopsy standards introduced in the UK in 2010 were intended to reduce variation and improve practice. A concurrent national drive was aimed at building robust paediatric nephrology networks to ensure services cater for the needs of the family and minimise time away from home. We aimed to identify current national practice since these changes on behalf of the British Association for Paediatric Nephrology.

Methods

All UK paediatric nephrology centres were invited to complete a survey of their biopsy practice, including advance preparation. From 1 January to 30 June 2012, a national prospective audit of renal biopsies was undertaken at participating centres comparing practice with the British Association for Paediatric Nephrology (BAPN) standards and audit results from 2005.

Results

Survey results from 11 centres demonstrated increased use of pre-procedure information leaflets (63.6 % vs 45.5 %, P = 0.39) and play preparation (90.9 % vs 9.1 %, P = 0.0001). Audit of 331 biopsies showed a move towards day-case procedures (49.5 % vs 32.9 %, P = 0.17) and reduced major complications (4.5 % vs 10.4 %, P = 0.002). Biopsies with 18-gauge needles had significantly higher mean pass rates (3.2 vs 2.3, P = 0.0008) and major complications (15.3 % vs 3.3 %, P = 0.0015) compared with 16-gauge needles.

Conclusions

Percutaneous renal biopsy remains a safe procedure in children, thus improving family-centered service provision in the UK.

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Acknowledgments

We thank participating centres: Alder Hey Children’s Hospital in Liverpool, Birmingham Children’s Hospital, Bristol Royal Hospital for Children, Children’s Kidney Centre in Cardiff, Evelina London Children’s Hospital, Great Ormond Street Hospital in London, Imperial College NHS Trust, Leeds Children’s Hospital, Nottingham Children’s Hospital, Royal Manchester Children’s Hospital, Great North Children’s Hospital in Newcastle Upon Tyne and Southampton General Hospital.

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Authors and Affiliations

  1. Birmingham Childrens Hospital, Steelhouse Lane, Birmingham, UK, B4 6NH

    Asheeta Gupta & Catherine O’Brien

  2. Oxford University Hospitals, Oxford, UK

    Joanna Campion-Smith

  3. Bristol Royal Hospital for Children, Bristol, UK

    Wesley Hayes & Carole Inward

  4. Imperial College NHS Trust, London, UK

    Jane E. Deal

  5. Southampton General Hospital, Southampton, UK

    Rodney D. Gilbert

  6. Alder Hey Children’s Hospital in Liverpool, Liverpool, UK

    Brian A. Judd

  7. Children’s Kidney Centre in Cardiff, Cardiff, UK

    Rajesh G. Krishnan

  8. Great Ormond Street Hospital in London, London, UK

    Stephen D. Marks

  9. Royal Manchester Children’s Hospital, Manchester, UK

    Mohan Shenoy

  10. Evelina London Children’s Hospital, London, UK

    Manish D. Sinha

  11. Great North Children’s Hospital, Newcastle Upon Tyne, UK

    Yincent Tse

  12. Leeds Children’s Hospital, Leeds, UK

    Kay Tyerman

  13. Nottingham Children’s Hospital, Nottingham, UK

    Meeta Mallik & Farida Hussain

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Correspondence to Asheeta Gupta.

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Gupta, A., Campion-Smith, J., Hayes, W. et al. Positive trends in paediatric renal biopsy service provision in the UK: a national survey and re-audit of paediatric renal biopsy practice. Pediatr Nephrol 31, 613–621 (2016). https://doi.org/10.1007/s00467-015-3247-7

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