Pediatric percutaneous renal biopsies: comparison of complications between real-time ultrasound guidance and pre-procedure ultrasound-aided skin-marking techniques

Background Percutaneous renal biopsy is a commonly performed procedure that guides decision-making for children with renal disease. Objective To compare complications from renal biopsies using real-time ultrasound (US) guidance versus pre-procedure US-aided skin-marking in children. Materials and methods We conducted a priori power analysis using a risk-adjusted model, which indicated we needed a sample size of 643–714 procedures (effect size: 0.8). Then we retrospectively identified consecutive patients who underwent a percutaneous renal biopsy from Jan. 1, 2012, to Dec. 31, 2016. We categorized complications according to the Society of Interventional Radiology (SIR) criteria and compared rates using the Fisher exact test. We analyzed complication predictors using multivariate regression. Results The study consisted of 701 percutaneous renal biopsies in 553 patients: 313 used real-time US guidance and 388 used pre-procedure US-aided skin-marking. Among the 254/701 (36%) complications, 56/313 (18%) resulted from real-time US guidance and 198/388 (51%) from pre-procedure US-aided skin-marking ( P