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NDT Advance Access published online on May 21, 2008
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfn253
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Successful interventional treatment of arteriovenous fistula after kidney biopsy in pediatric patients—a report of three cases

Eva Maria Rüth1, Katalin Dittrich1, Jörg Jüngert2, Michael Uder3, Wolfgang Rascher1 and Jörg Dötsch1

1 Department of Pediatric Nephrology, University Hospital, Erlangen, Germany 2 Department of Pediatrics, University Hospital, Erlangen, Germany 3 Department of Radiology, University Hospital, Erlangen, Germany

Correspondence and offprint requests to: Eva Maria Rüth, Department of Pediatric Nephrology, University Hospital, Loschgestr. 15, 91054 Erlangen, Germany. Tel: +49-9131-85-33118; Fax: +49-91-9131-85-33706; E-mail: Eva-Maria.Rueth{at}uk-erlangen.de



  Abstract

With an incidence of up to 16%, arteriovenous fistula (AVF) is a frequent complication after renal biopsy. We report on three cases, where renal biopsy in pediatric and adolescent patients led to various but clinically significant complications. In each patient two cores of renal parenchyma from the upper pole of the renal transplant or the lower pole of the right native kidney, respectively, were obtained with two attempts. Immediate post-bioptic ultrasound did not show any abnormalities. Setting of an AVF was suspected when complications occurred and ultrasound and Doppler studies showed AVF. The diagnosis was confirmed by angiography and occlusion of the fistulae was performed in the same session. We conclude that persistent AVF is an uncommon but serious complication after renal biopsy. Well-timed angiography when AVF is suspected can prevent loss of function, especially in transplant recipients.

Keywords: renal biopsy; arteriovenous fistula; pediatric renal transplants; interventional therapy

Received for publication: 4.11.07
Accepted in revised form: 14. 4.08


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