title: Percutaneous ultrasound-guided renal biopsy in children: The need for renal biopsy in pediatric patients with persistent asymptomatic microscopic hematuria.
abstract: BACKGROUND
  Percutaneous renal biopsy (PRB) is essential for the diagnosis, prognosis, and management of children with unknown kidney disease. In this study, the safety and efficacy of PRB is investigated, and also the common etiologies of childhood kidney disease, based on histological findings. In addition, we explored the role of PRBs in the diagnosis of children who presented with persistent asymptomatic hematuria.
  
  
  METHODS
  By chart review, from July 2005 to July 2009, a total of 99 PRBs were performed on 91 children (43 girls and 48 boys; mean age, 10.9 ± 4.4 years) under ultrasound (US) guidance, by a doctor, using an automated 18-gauge biopsy needle following the same protocol, at a medical center in northern Taiwan.
  
  
  RESULTS
  The accuracy of the histological diagnosis was excellent. The most common post-biopsy complications were perirenal hematoma (11.1%) and asymptomatic gross hematuria (3.0%), respectively. Nevertheless, these complications resolved spontaneously, and none had major bleeding episodes. Histological results showed that lupus nephritis, minimal change disease, and IgA nephropathy (IgAN) could be the current leading causes of childhood kidney diseases in Taiwan.
  
  
  CONCLUSIONS
  Automated ultrasound (US)-guided PRB is a safe and reliable method of assessing childhood renal disease. A recent study shows that the presence of persistent asymptomatic isolated microhematuria in adolescents is a predictive marker of future end-stage renal disease. Hence, the emphasis of renal biopsy on children with persistent asymptomatic hematuria is beneficial for the early diagnosis of IgAN or other glomerulonephritis (GN), which tends toward progressive kidney disease in adulthood without prompt therapeutic intervention.
authors.affiliation: Department of Pediatric Nephrology, Chang Gung Children's Hospital at Linkou, Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Mei-Ching
authors.initials: MC
authors.lastname: Yu
authors.forename: Fan
authors.initials: F
authors.lastname: Lee
authors.forename: Wen-Hung
authors.initials: WH
authors.lastname: Huang
authors.forename: Swei
authors.initials: S
authors.lastname: Hsueh
mesh_terms: D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis / Q000000981:diagnostic imaging; D006417:Hematuria / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D008297:Male; D009392:Nephrectomy / Q000379:methods; D011379:Prognosis; D014463:Ultrasonography