| Complication of Percutaneous Renal Biopsy in Children. |
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Seo Jeong Kim, Jae Seung Lee, Pyung Kil Kim |
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Department of Pediatrics, Yonsei University, College of Medicine, Seoul, Korea |
| 소아에서 시행한 경피적 신생검의 문제점에 대한 고찰 |
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김 서 정, 이 재 승, 김 병 길 |
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연세대학교 의과대학 소아과학교실 |
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| Abstract |
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Percutaneous renal biopsy is presently used more widely and selectively with fewer complications
and a higher success rate than in the past. The improved methods of renal biopsy tissue handling and
staining and the correlation of light microscopy results with those of electron and immunofluorescent
microscopy have led to a quantum increase in our knowledge of renal diseases and have given great
impetus to the developing field of nephrology, a medical subspecialty.
The clinical problems of 502 percutaneous renal biopsies performed in 475 children with renal
diseases at Severance Hospital from July 1978 to June 1986 were reviewed in this study.
The results are as follows.
1) The children ranged in age from 6 months to 16 years and included 346 males and 129 females.
2) Primary diseases were nephrotic syndrome in 30.9% of the cases, benign recurrent hematuria in 16.0%, IgA nephropathy in 15.4%, and Henoch-Schdnlein purpuric nephritis and poststreptococcal
glomerulonephritis in 14.5% and 14.1% respectively.
3) In 96.4% of the cases biopsies were obtained which could be examined and in 1.4% of the cases
the biopsies were inadequate for examination. No specimens were obtained in 2.2% of the cases.
4) Mild complications were observed in 19.5% of the patients and included gross hematuria, flank
pain, abdominal discomfort and an increase in hematuria which disappeared spontaneously within 48
hours, while serious complications developed in 5.2% of the cases including gross hematuia, flank
pain, abdominal discomfort, and voiding difficulty which persisted more than 48 hours. Five cases of
perirenal hematoma, 11 cases of transfusion, and one nephrectomy due to hemorrhage were also
serious complications. 5) There was no correlation between complication and failure rates and the age and primary disease of the children. 6) The incidence of complication and failure was similar in both blind biopsy and biopsy with fluoroscopy. 7) Complications were observed more frequently in children with high BUN levels, but there was no relationship between preexisting hypertension and the repetition of renal biopsies with complications.
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| Key Words:
Percutaneous renal biopsy, Complication
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