title: Positive trends in paediatric renal biopsy service provision in the UK: a national survey and re-audit of paediatric renal biopsy practice.
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.
authors.affiliation: Birmingham Childrens Hospital, Steelhouse Lane, Birmingham, UK, B4 6NH. asheetagupta@doctors.net.uk.
authors.forename: Asheeta
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Oxford University Hospitals, Oxford, UK.
authors.forename: Joanna
authors.initials: J
authors.lastname: Campion-Smith
authors.affiliation: Bristol Royal Hospital for Children, Bristol, UK.
authors.forename: Wesley
authors.initials: W
authors.lastname: Hayes
authors.affiliation: Imperial College NHS Trust, London, UK.
authors.forename: Jane E
authors.initials: JE
authors.lastname: Deal
authors.affiliation: Southampton General Hospital, Southampton, UK.
authors.forename: Rodney D
authors.initials: RD
authors.lastname: Gilbert
authors.affiliation: Bristol Royal Hospital for Children, Bristol, UK.
authors.forename: Carole
authors.initials: C
authors.lastname: Inward
authors.affiliation: Alder Hey Children's Hospital in Liverpool, Liverpool, UK.
authors.forename: Brian A
authors.initials: BA
authors.lastname: Judd
authors.affiliation: Children's Kidney Centre in Cardiff, Cardiff, UK.
authors.forename: Rajesh G
authors.initials: RG
authors.lastname: Krishnan
authors.affiliation: Great Ormond Street Hospital in London, London, UK.
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Marks
authors.affiliation: Birmingham Childrens Hospital, Steelhouse Lane, Birmingham, UK, B4 6NH.
authors.forename: Catherine
authors.initials: C
authors.lastname: O'Brien
authors.affiliation: Royal Manchester Children's Hospital, Manchester, UK.
authors.forename: Mohan
authors.initials: M
authors.lastname: Shenoy
authors.affiliation: Evelina London Children's Hospital, London, UK.
authors.forename: Manish D
authors.initials: MD
authors.lastname: Sinha
authors.affiliation: Great North Children's Hospital, Newcastle Upon Tyne, UK.
authors.forename: Yincent
authors.initials: Y
authors.lastname: Tse
authors.affiliation: Leeds Children's Hospital, Leeds, UK.
authors.forename: Kay
authors.initials: K
authors.lastname: Tyerman
authors.affiliation: Nottingham Children's Hospital, Nottingham, UK.
authors.forename: Meeta
authors.initials: M
authors.lastname: Mallik
authors.affiliation: Nottingham Children's Hospital, Nottingham, UK.
authors.forename: Farida
authors.initials: F
authors.lastname: Hussain
mesh_terms: D000293:Adolescent; D001706:Biopsy / Q000009:adverse effects / Q000592:standards / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000592:standards / Q000639:trends*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008485:Medical Audit; D009398:Nephrology / Q000592:standards / Q000639:trends*; D018802:Patient-Centered Care / Q000639:trends; D010372:Pediatrics / Q000592:standards / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019984:Quality Indicators, Health Care / Q000639:trends; D013222:State Medicine / Q000592:standards / Q000639:trends*; D006113:United Kingdom; D055815:Young Adult
keywords: Complications; Paediatric; Renal biopsy; UK National Standards