Globally with an annual incidence rate of 8%, renal disease is becoming a common problem among children [1]. The burden and pattern of renal disease among children in developing countries like India are unknown. Furthermore, there is evidence of a recent shift in the Spectrum of renal illnesses in various regions of the world [2]. Renal biopsy is a well-known diagnostic method for evaluating kidney disorders in children. The disorders discovered on percutaneous renal biopsies vary widely based on various parameters, including age, gender, race, geographic location, and the type of the biopsy reasons. Country-based renal biopsy registries exist in many regions of the world, but no such policy is seen in India [3-5]. In India, a few hospital-based studies [6,7]. have been conducted, but there is little information available on the population of South India.

This study aims to investigate the indications of renal biopsy in the south Indian paediatric population, to evaluate the histopathological pattern in a tertiary care centre.

The present study is a descriptive prospective hospital-based study. We looked at renal biopsies conducted at a single centre NRI medical college and general hospital in children under 14 from January 2019 to August 2021. Pediatric nephrologists used 18-gauge renal biopsy needles to perform all of the biopsies under ultrasound supervision.

Sample size: 41 cases under the age of 14 were included in the study. Prior consent was taken from guardians of the study population.

All data, including age, gender, indication for kidney biopsy, and histological diagnosis, was recorded after the study was approved by the Institutional Ethical and Review committee. After blood work, an interventional radiologist did ultrasound-guided kidney biopsies under general anesthesia. Before and immediately after the biopsy, all patients had a renal ultrasound, and the children were monitored for vital signs and any changes in urine colour or volume. All of the patients had a

This research provides the frequency of ‘Biopsy proved renal diseases’ among children in the south Indian population over two and half years. The majority were males and below five years in the study population (mean age -6 years). Anochie I et al. [8] and Rahman MH et al. [9] also had similar male predominance in renal diseases among children. Al-Sadoon EI et al. [10] did a similar in Saudi Arabia, which showed 7.3 years as the mean age, almost similar to the present study. Mohapatra A et al. [11] did a similar study on the South Asian population where it showed 12.8 years which is way higher than the present study's mean age. Gender distribution was similar to other studies done in Brazilian, Serbian, and Korean studies [12-14]. The differences in gender may be due to the gender-based discrimination of health-seeking present in developed countries like India.

Steroid Resistant Nephrotic Syndrome was the most common indication for renal biopsy in the present study. A similar study done in North India by Kanodia KV et al [15]. had similar frequent indications (Nephrotic syndrome -46.2%) in their study which supports the present study. A Chinese study was done by Nie S et al [16]. also had Nephrotic syndrome had the main indication (50%) for renal biopsy in their child study population.

In a study done in Saca, Edward et al [17]. also had steroid-resistant nephrotic syndrome accounting as the main indication for biopsy in their study which supports the present study. Saudi Arabian study by Al-Sadoon EI et al [10]. also had nephrotic syndrome in 58.9% as an indication.

Minimal change disease (46.3%) is the most frequent histopathological diagnosis in the present study.