C CUI1, R KANAGARATNAM1, N GRAF2, A DURKAN2
1University of Sydney, Camperdown, Australia, 2Children’s Hospital at Westmead, Westmead, Australia
Background: Renal biopsy is commonly used in the diagnosis of kidney diseases. Increasingly in paediatric practice, biopsies are done under general anaesthetic by interventional radiologists, who perform their own ultrasound compared to nephrologists who use ultrasonographer guided ultrasound in a sedated child. Both sets of operators use spring-loaded automated biopsy guns with same gauged needles. The sample adequacy and complication rates have not been determined in the two groups.
Aims: To compare biopsy size and adequacy between radiologists and nephrologists and to compare complication rates.
Methods: We examined consecutive kidney biopsies done between Jan 2008 and Dec 2017 and probed the electronic medical records of patients for data regarding complications.In native biopsies, successful processing for light microscopy, immunofluorescence, and electron microscopy was used as proxy for specimen adequacy. In transplant biopsies, adequate specimens contained at least 10 glomeruli and 2 arteries, as per the Banff criteria.Data were analysed using Mann–Whitney U test and Pearson’s chi-squared test in SPSS .
Results: Radiologists performed 112 of the 355 biopsies obtained. Radiologists obtained more renal cores (median number 3 vs 2, p<0.001), more total glomeruli (median number 32 vs 15, p<0.001), and more glomeruli per core (median number 12.0 vs 7.0, p<0.001). There were no differences in specimen adequacy of native renal biopsies between two groups but radiologists obtained more adequate transplant biopsy specimens (95.0% vs 51.6%, p<0.001).There were no significant differences in complications including haematoma, bleeding, de novo haematuria, transfusion requirement, infections or AV fistula formation between two groups.
Conclusion: Radiologists obtained significantly larger specimens than nephrologists. There were no significant differences in post procedural complications.
Chen Cui is a final year medical student from University of Sydney who has a special interest in nephrology.