COMPLICATIONS AND SAFETY OF POST PERCUTANEOUS RENAL BIOPSY IN PAEDIATRIC PATIENTS.

BACKGROUND: Renal biopsy is gold standard in diagnosis of various renal diseases. Though it is safe yet it requires adequate patient evaluation, preparation and monitoring after the procedure. METHODS: This descriptive case series was conducted in the Paediatric Nephrology Department, The Children's Hospital Lahore over a period of one year. Children aged less than 16 years were included who were suffering from renal diseases requiring renal biopsy for diagnosis. After renal biopsy patients were monitored for complications and were discharged after short stay of eight hours who got no complication during the observation period. RESULTS: Out of total 145 patients, 97 (66.1%) were males and 48 (33.9%) were females. The age range was from 0.7 years to 16 years. The duration of stay after renal biopsy was up to eight hours in 131 (90.34%) patients, while 14 (9.66%) stayed longer. Post-biopsy stay of 24 hours was observed in 8 patients and 48 hours in 5 patients. Only 1 patient stayed for 96 hours. Patients with gross haernaturia were 6 (4.1%) who were checked for perinephric hematoma formation by ultrasonography. Only one patient required blood transfusion along with fresh frozen plasma. The most common histopathological diagnosis was Mesangioproliferative with 67 (46.2%) cases, followed by Glomerulonephritis in 35 (24.1%) patients having Membranoproliferative Glomerulonephritis (MPGN) while Systemic Lupus Erythematous (SLE) nephritis was reported in 15 (10.35%) patients. CONCLUSION: Patients can be discharged after short stay post renal biopsy procedure provided done after proper screening of patients. As it not only reduces patient stay but also is cost effective.

HISTOPATHOLOGICAL PATTERNS IN PAEDIATRIC IDIOPATHIC STEROID RESISTANT NEPHROTIC SYNDROME.

BACKGROUND: Steroid-resistant nephrotic syndrome (SRNS) is a common problem but difficult to treat for pediatric nephrologists. Due to paucity of studies done in few centres in southern Pakistan regarding the histopathological aspects in paediatric patients with SRNS, this study was conducted to determine the histopathological spectrum in children with SRNS at our centre. METHODS: This descriptive study has been conducted at the Nephrology department, The Children's Hospital Lahore from February 2014 to January 2015. Based upon history, physical examination and laboratory results, all patients diagnosed as idiopathic SRNS were included in the study and renal biopsy was done to determine the underlying pathology. Histopathology reports were retrieved and data analysis done using SPSS-20.0. RESULTS: There were a total of 96 patients, 64 (66.7%) males and 32 (33.3%) females. The age range was from 0.80 to 15 years with mean age of presentation being 6.34+3.75 years. The most common histo-pathological pattern was mesangio-proliferative Glomerulonephritis found in 79 (82.3%) cases followed by Focal segmental glomerulosclerosis (FSGS) in 9 (9.4%) patients while Minimal change disease (MCD) was seen in 5 (5.2%) subjects. CONCLUSION: Mesangioproliferative glomerulonephritis is the most common histological pattern seen in children presenting with idiopathic SRNS at our centre followed by FSGS and MCD.