Percutaneous Kidney Biopsy and the Histopathologic Patterns of Kidney Diseases in Children: An Observational Descriptive Study at a South‑East Nigerian Tertiary Hospital

Abstract

Background: Kidney biopsy remains the best standard for kidney tissue analysis. Although percutaneous kidney biopsy is an invasive  procedure, it is an indispensable part of interventional nephrology for accurate diagnosis, selection of appropriate therapy protocol, and  prognostication of kidney diseases in children. With improvement in expertise among pediatric nephrologists, data on procedure outcomes are now being documented.

Aim: We aimed to describe the outcomes in a 5-year practice of kidney biopsy at the pediatric  nephrology unit in a southeast Nigerian tertiary hospital.

Patients and Methods: An observational descriptive study conducted on the  kidney biopsy performed in our facility from 2017 to 2022. The focus was on the patients’ clinical profile, indications for biopsy, the adopted procedure, and the histopathologic findings.

Results: A total of 69 patients had kidney biopsy, 40 (58.0%) were males, while 29  (42.0%) were females. Sixty‑four (92.7%) patients had the procedure at the age of >10 years, while five (7.2%) at the age of <7 years. The  patients’ prebiopsy mean systolic and diastolic blood pressures were 111.20 ± 16.93 and 74.64 ± 12.69 mmHg, respectively. Their estimated glomerular filtration rate (eGFR) was 119.27 ± 52.78 ml/min/1.73 m² . The most frequent indication was steroid resistance  (39/69, 56.5%). Focal segmental glomerulosclerosis was the commonest histopathologic finding (38/69, 55.0%).

Conclusion: Outcomes of  percutaneous kidney biopsy at a Nigerian tertiary hospital are adjudged successful. The histopathologic patterns highlight FSGS as the  major cause of steroid resistance in childhood nephrotic syndrome in this clime.