Success and safety of same-day kidney biopsy in children and adolescents

Renal biopsy is crucial for the diagnosis, management, and monitoring of ma ny kidney diseases. Although percutaneous renal biopsy is considered a rout ine safe procedure in children, the optimal length of in-hospital observati on following the procedure is not yet known. We prospectively studied two c omparable groups of children to compare the success and safety of performin g native renal biopsy as an outpatient procedure versus keeping the childre n hospitalized post biopsy. Doppler ultrasonography of the biopsied kidney was performed approximately weeks after the procedure. For 40 children the biopsy was performed on a same-day basis (study group) and another 15 child ren were kept for overnight observation (control group). All biopsies yield ed adequate tissue for histopathological diagnosis. There was no difference between the two groups in the amount of reported pain and analgesics used after the procedure. Only 1 child in the study group was readmitted 5 days after the biopsy for 48 h, but no major complications were detected. The in cidence of post-biopsy intra- or perirenal hematoma detection by sonography was not statistically different between the two groups (39% study group, 4 3% control group). Follow-up imaging studies were performed on 10 of the 20 children who had an early post-biopsy hematoma and all were completely nor mal. Patients and their families appreciated being discharged home the same day. In addition, total charges for hospitalization were significantly les s for the: study group than the control group. We conclude that in selected patients, same-day discharge after renal biopsy may be performed safely wi thout an increased risk of complications.