BACKGROUND Percutaneous ultrasound-guided renal biopsy (PURB) is an invasive but essential procedure in establishing the histologic diagnosis of pediatric renal diseases. Large studies which describe PURB complications and its contributory risk factors are scarce in the pediatric literature. METHODS Patients who underwent real-time PURB from September 2011 to August 2017 were retrospectively reviewed. Data pertaining to clinical characteristics, histologic diagnosis and biopsy-related complications were collected. In addition, the risk factors for complications were also analyzed. RESULTS Overall, 183 patients (109 females) were enrolled and 201 biopsies were obtained. The mean age was 14.4 ± 13.7 years. Over 98% of the biopsies were considered adequate in quality. The major complications were perirenal hematoma requiring blood transfusion (4 cases, 2.0%), followed by perirenal abscess (1 case, 0.5%) and arteriovenous fistula (1 case, 0.5%). All patients recovered without sequelae after treatment. Hypertension, low estimated glomerular filtration rate (eGFR) and anemia were more common in patients with complication than in those without. Further logistic regression model analysis demonstrated that eGFR <30 ml/1.73m2/min was an independent risk factor for major complications. CONCLUSIONS Perirenal hematoma needing blood transfusion is the most common major complication for children undergoing renal biopsy. Low eGFR is an independent risk factor for major complications. Early recognition and timely treatment should be delivered to children with renal function impairment accordingly.

中文翻译：

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儿童经皮超声引导下肾活检并发症的危险因素。

背景技术经皮超声引导下肾活检（PURB）是建立儿童肾脏疾病的组织学诊断的一种侵入性但必不可少的程序。儿科文献中缺乏描述PURB并发症及其相关危险因素的大型研究。方法回顾性分析2011年9月至2017年8月接受实时PURB治疗的患者。收集有关临床特征，组织学诊断和活检相关并发症的数据。此外，还分析了并发症的危险因素。结果总共招募了183例患者（109名女性），并获得了201例活检。平均年龄为14.4±13.7岁。超过98％的活检标本被认为是足够的。主要并发症为需要输血的肾周血肿（4例，占2.0％），其次是肾周脓肿（1例，占0.5％）和动静脉瘘（1例，占0.5％）。所有患者治疗后均无后遗症。与没有并发症的患者相比，并发症患者的高血压，估计的肾小球滤过率低和贫血更为常见。进一步的逻辑回归模型分析表明，eGFR <30 ml / 1.73m2 / min是发生重大并发症的独立危险因素。结论需要输血的肾小球血肿是接受肾脏活检的儿童最常见的主要并发症。低eGFR是发生重大并发症的独立危险因素。肾功能受损的儿童应及早识别并及时治疗。其次是肾周脓肿（1例，0.5％）和动静脉瘘（1例，0.5％）。所有患者治疗后均无后遗症。与没有并发症的患者相比，合并症患者中高血压，估计的肾小球滤过率（eGFR）低和贫血更为常见。进一步的逻辑回归模型分析表明，eGFR <30 ml / 1.73m2 / min是发生重大并发症的独立危险因素。结论需要输血的肾小球血肿是接受肾脏活检的儿童最常见的主要并发症。低eGFR是发生重大并发症的独立危险因素。肾功能受损的儿童应及早识别并及时治疗。其次是肾周脓肿（1例，0.5％）和动静脉瘘（1例，0.5％）。所有患者治疗后均无后遗症。与没有并发症的患者相比，并发症患者的高血压，估计的肾小球滤过率低和贫血更为常见。进一步的逻辑回归模型分析表明，eGFR <30 ml / 1.73m2 / min是发生重大并发症的独立危险因素。结论需要输血的肾小球血肿是接受肾脏活检的儿童最常见的主要并发症。低eGFR是发生重大并发症的独立危险因素。肾功能受损的儿童应及早识别并及时治疗。所有患者治疗后均无后遗症。与没有并发症的患者相比，并发症患者的高血压，估计的肾小球滤过率低和贫血更为常见。进一步的逻辑回归模型分析表明，eGFR <30 ml / 1.73m2 / min是发生重大并发症的独立危险因素。结论需要输血的肾小球血肿是接受肾脏活检的儿童最常见的主要并发症。低eGFR是发生重大并发症的独立危险因素。肾功能受损的儿童应及早识别并及时治疗。所有患者治疗后均无后遗症。与没有并发症的患者相比，并发症患者的高血压，估计的肾小球滤过率低和贫血更为常见。进一步的逻辑回归模型分析表明，eGFR <30 ml / 1.73m2 / min是发生重大并发症的独立危险因素。结论需要输血的肾小球血肿是接受肾脏活检的儿童最常见的主要并发症。低eGFR是发生重大并发症的独立危险因素。肾功能受损的儿童应及早识别并及时治疗。进一步的逻辑回归模型分析表明，eGFR <30 ml / 1.73m2 / min是发生重大并发症的独立危险因素。结论需要输血的肾小球血肿是接受肾脏活检的儿童最常见的主要并发症。低eGFR是发生重大并发症的独立危险因素。肾功能受损的儿童应及早识别并及时治疗。进一步的逻辑回归模型分析表明，eGFR <30 ml / 1.73m2 / min是发生重大并发症的独立危险因素。结论需要输血的肾小球血肿是接受肾脏活检的儿童最常见的主要并发症。低eGFR是发生重大并发症的独立危险因素。肾功能受损的儿童应及早识别并及时治疗。