Is kidney biopsy necessary in children with idiopathic nephrotic syndrome?
(2023) In Acta Pædiatrica 112(12). p.2611-2618- Abstract
AIM: To investigate the need, in the Northern European setting, to perform kidney biopsy in children with steroid-sensitive nephrotic syndrome.
METHODS: In this retrospective study 124 individuals aged 1-18 years with idiopathic nephrotic syndrome, followed in the paediatric hospitals in southern Sweden from 1999 to 2018, were included.
RESULTS: There was a median follow-up time of 6.5 (0.2-16.8) years. The majority (92%) of children were steroid-sensitive and of them, 60.5% were frequently relapsing or steroid-dependent. Microscopic haematuria was found at onset in 81.1% and hypertension in 8.7%. At least one kidney biopsy was performed in 93 (75%). The most common indication was a steroid-dependent or relapsing course... (More)
AIM: To investigate the need, in the Northern European setting, to perform kidney biopsy in children with steroid-sensitive nephrotic syndrome.
METHODS: In this retrospective study 124 individuals aged 1-18 years with idiopathic nephrotic syndrome, followed in the paediatric hospitals in southern Sweden from 1999 to 2018, were included.
RESULTS: There was a median follow-up time of 6.5 (0.2-16.8) years. The majority (92%) of children were steroid-sensitive and of them, 60.5% were frequently relapsing or steroid-dependent. Microscopic haematuria was found at onset in 81.1% and hypertension in 8.7%. At least one kidney biopsy was performed in 93 (75%). The most common indication was a steroid-dependent or relapsing course (58.4%). One of 79 steroid-sensitive children had another histological diagnosis than minimal change nephropathy 1.3%, 95% confidence interval (0.002, 0.068). Bleeding occurred after eight biopsies (6.6%). Twenty individuals (30.7%) were transferred to adult units, 18 still on immunosuppression.
CONCLUSION: We have in our cohort of unselected children with idiopathic nephrotic syndrome confirmed that a kidney biopsy rarely gives important medical information in steroid-sensitive children without any other complicating factor and that the liberal policy of kidney biopsy in the Nordic countries safely can be changed.
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- author
- Bekassy, Zivile LU ; Lindström, Martin LU ; Rosenblad, Therese LU ; Aradóttir, Sunna LU ; Sartz, Lisa LU and Tullus, Kjell
- organization
- publishing date
- 2023-08-29
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Acta Pædiatrica
- volume
- 112
- issue
- 12
- pages
- 2611 - 2618
- publisher
- Wiley-Blackwell
- external identifiers
-
- scopus:85169012485
- pmid:37642221
- ISSN
- 0803-5253
- DOI
- 10.1111/apa.16959
- language
- English
- LU publication?
- yes
- id
- 6f643e32-f5b0-4cc8-8461-3d5d5e7ed250
- date added to LUP
- 2023-09-11 13:30:26
- date last changed
- 2024-04-20 03:03:01
@article{6f643e32-f5b0-4cc8-8461-3d5d5e7ed250,
abstract = {{<p>AIM: To investigate the need, in the Northern European setting, to perform kidney biopsy in children with steroid-sensitive nephrotic syndrome.</p><p>METHODS: In this retrospective study 124 individuals aged 1-18 years with idiopathic nephrotic syndrome, followed in the paediatric hospitals in southern Sweden from 1999 to 2018, were included.</p><p>RESULTS: There was a median follow-up time of 6.5 (0.2-16.8) years. The majority (92%) of children were steroid-sensitive and of them, 60.5% were frequently relapsing or steroid-dependent. Microscopic haematuria was found at onset in 81.1% and hypertension in 8.7%. At least one kidney biopsy was performed in 93 (75%). The most common indication was a steroid-dependent or relapsing course (58.4%). One of 79 steroid-sensitive children had another histological diagnosis than minimal change nephropathy 1.3%, 95% confidence interval (0.002, 0.068). Bleeding occurred after eight biopsies (6.6%). Twenty individuals (30.7%) were transferred to adult units, 18 still on immunosuppression.</p><p>CONCLUSION: We have in our cohort of unselected children with idiopathic nephrotic syndrome confirmed that a kidney biopsy rarely gives important medical information in steroid-sensitive children without any other complicating factor and that the liberal policy of kidney biopsy in the Nordic countries safely can be changed.</p>}},
author = {{Bekassy, Zivile and Lindström, Martin and Rosenblad, Therese and Aradóttir, Sunna and Sartz, Lisa and Tullus, Kjell}},
issn = {{0803-5253}},
language = {{eng}},
month = {{08}},
number = {{12}},
pages = {{2611--2618}},
publisher = {{Wiley-Blackwell}},
series = {{Acta Pædiatrica}},
title = {{Is kidney biopsy necessary in children with idiopathic nephrotic syndrome?}},
url = {{http://dx.doi.org/10.1111/apa.16959}},
doi = {{10.1111/apa.16959}},
volume = {{112}},
year = {{2023}},
}