Outcome of pediatric renal biopsy with monopty gun technique

ABSTRACT

To determine the outcome of percutaneous renal biopsy [PRB] using Monopty-gun technique [MGT] and to compare the results of sedation with general anesthesia [GA] used for the procedure. Descriptive Study. Department of Pediatrics at National Institute of Child Health [NICH] and the Kidney Center Postgraduate Training Institute [KPTI], Karachi from June 2005 to February 2010. Renal biopsies were performed either under sedation /GA at NICH and KPTI respectively using MGT under ultrasound guidance [USG] after routine tests. A resident/ nurse monitored the procedure. Data including age, sex, indication, vitals monitored, number of attempts per patient, glomeruli per biopsy and complications were recorded. Using statistical-Package-Scientific-Software [SPSS] version- 15, descriptive statistics were applied. Paired test was used to compare pre-and- post procedure vitals. P<0.0 was considered significant. A total of 147 biopsies in 145 children were performed. Boys were 79 [54.58%] and girls 66 [45.51%]. Mean age was 7.31 +/- 4.23 years. Most of the procedures were performed under sedation [n 105, 71.42%]. Indication were nephritic syndrome [NS] in 96[65.3%], secondary glomerulonephritis [SGN] in 17 [11.6%], nephritic-nephrotic syndrome [NNS] in 16 [10.9%], congenital nephritic syndrome [NS] in 15[10.2%] and others 3[2.06%]. The success and adequacy rate was 95.91% and 95.23% respectively. Failure occurred in 5[3.4%] cases. Overall, 26[17.68%] complications were observed in 21[14.28%] patients with 6[4%] being major. Technique related complications [20, 76.92%] were more than sedation/GA related [SGRC-n 6.23%]. The complications were more in sedation but the outcome was better in GA. MGT is a safe for PRB in children. The success, adequacy and complication rates in our study are in uniformity with the current standards