Safety of paediatric percutaneous native kidney biopsy and factors predicting bleeding complications

Aim Data on safety of paediatric percutaneous native kidney biopsy (PNKB) using automated biopsy devices and real-time ultrasonography are lacking. The objective of this study was to evaluate the safety and to identify factors predicting bleeding complications associated with this PNKB protocol. Methods A total of 227 patients aged PNKB were analyzed. The primary outcome was bleeding complications divided into minor and major bleeding complications. Minor bleeding complications included perirenal haematoma and macroscopic haematuria. Major bleeding complications included requirement of blood transfusion, a higher level of care or vasopressors to maintain haemodynamic stability, requirement of angiographic or surgical intervention, or death. Results Perirenal haematoma occurred in 58 patients (25%) and macroscopic haematuria occurred in 46 patients (20%). Two factors were independently associated with perirenal haematoma in a multivariate model. These were male gender and weight for height Z-score <-0.5. Three patients (1.3%), all with perirenal haematoma had major bleeding complications (two required blood transfusion and one underwent surgery to repair an injured renal artery). Conclusions The favourable safety information from our study is useful when counselling the parents and patients undergoing similar protocols. PNKB can be safely performed when precautions are taken to prevent bleeding. Selection of biopsy instruments should be tailored according to patient size.