Spectrum of biopsy-proven renal disease in the pediatric age group at King Hussein Medical Center

ABSTRACT

This is a retrospective analysis of kidney biopsies done for children with glomerular diseases in the pediatric age group. The medical records of all children who underwent kidney biopsy between January 1999 and June 2003 were studied. Demographic data including age and gender, as well as the indication for biopsy, the result, the diagnostic value, and complications of the procedure were recorded. All biopsies were done under ultrasound guidance. A total number of 65 biopsies were done. Four were in previously diagnosed patients to rule out cyclosporine toxicity and therefore excluded from the study The biopsy was inadequate in three cases [46%] All of the remaining 58 biopsies were included in the study and analyzed. The mean age at biopsy was 7.56 +/- 4.22 years. Renal disease was more common in males [62.1%]. The most common indication for biopsy was steroid resistant nephrotic syndrome accounting for 32.7% of the cases. The most common primary glomerular disease at renal biopsy was focal segmental glomerulosclerosis occurring in 19% of patients followed by mesangiocapillary glomerulo-nephritis and then minimal change disease. The most common secondary renal disease was Henoch-Schoenlein purpura representing 6.9% of cases followed by systemic lupus erytheniatosus in 3.4% of eases. The kidney biopsy was normal in 5.2% of patients. When patients with difficult nepbrotic syndrome were analyzed the most common lesion was local segmental glomerulosclerosis in 39.1%. Mesangiocapillary glomerulonephritis was present in 26.1%, minimal change disease in 17.4%, diffuse mesangial nephritis in 13% and congenital nephrotic syndrome in 4.3%. Gross hematuria was noticed in eight [13.8%] patients' however blood transfusion was only needed in two [3.4%] patients. One patient [1.7%] required radiological intervention for AV fistula post biopsy. The distribution of renal disease in the pediatric age group at King Hussein Medical Center is similar to that described in other countries with some differences. The kidney biopsy is safe and the diagnostic yield is excellent. Taking into account the lack of reliable data in Jordan this study illustrates die importance of having a regional registry for renal disease in children