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Renal Biopsy

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By Isabel Acosta-Ochoa Nephrology senior staff. Valladolid. Spain
Fernando C Fervenza, Sanjeev Sethi
The number of obese and morbidly obese patients is increasing and so is the burden of renal disease in these patients. In a large series of biopsies from the morbidly obese patient population, Choung et al. show that there is heterogeneity in the renal disease affecting this population. It is imperative that the underlying renal disease in obese patients be correctly diagnosed for optimal management.
March 2019: Kidney International
Wang Haochen, Wang Jian, Song Li, Lv Tianshi, Tong Xiaoqiang, Zou Yinghua
OBJECTIVE: This study aimed to determine if superselective renal artery embolization is a safe and effective method of treating bleeding complications after percutaneous renal biopsy. METHODS: From January 2006 to December 2017, 43 patients (22 men and 21 women, mean age: 44.5 ± 14.0 years) underwent angiography for post-biopsy bleeding complications following percutaneous biopsy. Patients underwent angiography and superselective artery embolization. We recorded serum creatinine and hemoglobin values to assess the effect of embolization...
February 14, 2019: Journal of International Medical Research
Niloufar Torkamani, George Jerums, Paul Crammer, Alison Skene, David A Power, Sianna Panagiotopoulos, Michele Clarke, Richard J MacIsaac, Elif I Ekinci
Mesangial metrics reflect glomerular filtration surface area in diabetes. The point-sampled intercept (PSI) method is the conventional method to calculate these parameters. However, this is time consuming and subject to underestimation. We introduce a novel three-dimensional (3D) reconstruction method applicable to light microscopy to measure mesangial metrics. Transmission electron microscopy (TEM), PSI and our new 3D imaging methods were used to quantify mesangial metrics from 22 patients with type 2 diabetes, normo-, micro- and macroalbuminuria and an estimated glomerular filtration rate of <60 mL/min/1...
February 12, 2019: Scientific Reports
Alessia Cimadamore, Silvia Gasparrini, Francesco Massari, Matteo Santoni, Liang Cheng, Antonio Lopez-Beltran, Marina Scarpelli, Rodolfo Montironi
Liquid biopsy, based on the circulating tumor cells (CTCs) and cell-free nucleic acids has potential applications at multiple points throughout the natural course of cancer, from diagnosis to follow-up. The advantages of doing ctDNA assessment vs. tissue-based genomic profile are the minimal procedural risk, the possibility to serial testing in order to monitor disease-relapse and response to therapy over time and to reduce hospitalization costs during the entire process. However, some critical issues related to ctDNA assays should be taken into consideration...
February 7, 2019: Cancers
Brad H Rovin, Salem Almaani, Ana Malvar
Anti-phospholipase A2 receptor (PLA2R) antibody is a specific biomarker for primary membranous nephropathy (MN). Testing positive for anti-PLA2R has been postulated to establish a diagnosis of MN in the absence of a kidney biopsy. Bobart et al. tested this hypothesis and concluded that anti-PLA2R positivity is sufficient to diagnose primary MN and initiate treatment in a subset of patients with nephropathy. This biomarker, however, does not render the kidney biopsy obsolete, but encourages the application of molecular analyses to renal pathology to keep the biopsy relevant...
February 2019: Kidney International
Randy L Luciano, Gilbert W Moeckel
The kidney biopsy is an invaluable tool that has become the gold standard for the diagnosis of pathologic kidney diseases since the early 1950s. Throughout the years, immunohistologic and ultrastructural microscopy techniques have improved and provide more information on the cause and classification of kidney diseases than that available from simple light microscopy alone. Kidney biopsy has become a preferred method to obtain critical information that can be used in conjunction with serologic, urinary, and genetic testing to diagnose a variety of kidney diseases, both acute and chronic...
January 17, 2019: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Marc Pineton de Chambrun, Philippe Cluzel, Isabelle Brocheriou, Nicolas Bréchot, Guillaume Hékimian, Mohamed-Wafik Turki, Guillaume Franchineau, Philippe Rouvier, Simon Bourcier, Côme Bureau, Ania Nieszkowska, Loïc Le Guennec, Alexis Mathian, Zahir Amoura, Matthieu Schmidt, Alain Combes, Charles-Edouard Luyt
OBJECTIVES: Transvenous renal biopsy is an alternative way to obtain kidney samples from patients with bleeding risk factors (e.g., antiplatelet therapy and anticoagulation or coagulation disorders). This study was undertaken to determine the safety and diagnostic yield of transvenous renal biopsy of critically ill patients. DESIGN: Monocenter, retrospective, observational cohort study. SETTING: A 26-bed French tertiary ICU. PATIENTS: All patients undergoing in-ICU transvenous renal biopsy between January 2002 and February 2018...
January 2, 2019: Critical Care Medicine
Ehab Mohammed, Ahmed Atris, Issa Al Salmi, Lubna Al-Menawi, Faisal Shaheen, Suad Hannawi
Diabetic kidney disease (DKD), one of the most frequent microvascular complications of diabetes mellitus (DM), is the leading cause of end-stage kidney disease worldwide. We reviewed all kidney biopsies performed at the Royal Hospital, Muscat, Oman, between January 2005 and December 2016, and data of 51 DM patients were analyzed. Of the 51 patients, 54.9% were male and 45.1% were female. The mean age was 50.8 (47.1-55.2) years; 86% were between 25 and 64 years old. Edema was the main clinical presentation (70...
November 2018: Saudi Journal of Kidney Diseases and Transplantation
C Cousineau, T Kumar, J P Roszka, K L Lewinski, W Li, H D Kanaan, R Pullalarevu, D S Bedi, S R Cohn, D Samarapungavan, Ping L Zhang
INTRODUCTION: Frozen sections have been used for evaluating tumors and margins during daily practice in pathology with high specificity and sensitivity (>90% for both indices both at national level and in our department). The correlation between frozen section tissue for immunofluorescent (IF) studies and permanent sections for light microscopy, along with electron microscopy, is critical for constructing a final renal pathology diagnosis. METHODS: We studied the correlation between the frozen sections for IF studies and separate fragments of tissue for permanent light microscopic sections in our renal transplant biopsies for purposes of quality control...
December 2018: Transplantation Proceedings
Charles D Varnell, Hillarey K Stone, Jeffrey A Welge
BACKGROUND AND OBJECTIVES: Kidney biopsy is an essential tool for the diagnosis and treatment of patients with kidney disease; however, because of its invasive nature, bleeding complications may arise. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a meta-analysis of prospective or retrospective observational studies and randomized, controlled trials in pediatric patients undergoing native or transplant kidney biopsy in an inpatient or outpatient setting in MEDLINE-indexed studies from January 1998 to November 1, 2017 to determine the proportion of patients who develop hematoma, need blood transfusion, or need an additional intervention due to a complication after kidney biopsy...
January 7, 2019: Clinical Journal of the American Society of Nephrology: CJASN
Qian Li, Xueying Lin, Xi Zhang, Anthony E Samir, Ronald S Arellano
PURPOSE: To evaluate imaging-related hemorrhagic risk factors for ultrasound (US)-guided native kidney biopsy. MATERIALS AND METHODS: A retrospective review was conducted of adult patients who underwent US-guided native kidney biopsy at a single center between January 2006 and March 2016 and identified 37 of 551 patients (6.72%) with postbiopsy bleeding complications, including 11 major complications (2.00%; n = 11) and 26 minor complications (4.72%; n = 26). Ten patients with major complications and 20 with minor complications were matched with 20 control subjects each by propensity score matching based on age, needle size, number of cores, blood pressure, partial thromboplastin time, prothrombin time, platelet count, and estimated glomerular filtration rate...
December 6, 2018: Journal of Vascular and Interventional Radiology: JVIR
Maja Mizdrak, Katarina Vukojević, Natalija Filipović, Vesna Čapkun, Benjamin Benzon, Merica Glavina Durdov
BACKGROUND: In glomerular injury dendrin translocates from the slit diaphragm to the podocyte nucleus, inducing apoptosis. We analyzed dendrin expression in IgA glomerulonephritis and Henoch Schönlein purpura (IgAN/HSP) versus in podocytopathies minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS), and compared it to pathohistological findings and renal function at the time of biopsy and the last follow-up. METHODS: Twenty males and 13 females with median of age 35 years (min-max: 3-76) who underwent percutaneous renal biopsy and had diagnosis of glomerular disease (GD) were included in this retrospective study...
November 20, 2018: Diagnostic Pathology
Helen P Cathro, Steven S Shen, Luan D Truong
The value of histochemical analysis in the diagnosis of medical renal diseases has long been known, and its use continues currently. Depending on the particular disorder in question, a variety of "special" stains may be applied to renal biopsies. These include the periodic acid-Schiff, Masson trichrome, Jones, von Kossa, Verhoeff-van Gieson, Congo Red, and toluidine blue methods, among others. This review considers the application of such techniques in the assessment of vascular, glomerular, and tubulointerstitial lesions of the kidney...
November 2018: Seminars in Diagnostic Pathology
Dustin Carpenter, S Ali Husain, Corey Brennan, Ibrahim Batal, Isaac E Hall, Dominick Santoriello, Raphael Rosen, R John Crew, Eric Campenot, Geoffrey K Dube, Jai Radhakrishnan, M Barry Stokes, P Rodrigo Sandoval, Vivette D'Agati, David J Cohen, Lloyd E Ratner, Glen Markowitz, Sumit Mohan
BACKGROUND AND OBJECTIVES: Biopsies taken at deceased donor kidney procurement continue to be cited as a leading reason for discard; however, the reproducibility and prognostic capability of these biopsies are controversial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We compiled a retrospective, single-institution, continuous cohort of deceased donor kidney transplants performed from 2006 to 2009. Procurement biopsy information-percentage of glomerulosclerosis, interstitial fibrosis/tubular atrophy, and vascular disease-was obtained from the national transplant database...
October 25, 2018: Clinical Journal of the American Society of Nephrology: CJASN
A H Schuster, N Reimann
The demand for image-guided renal biopsy has increased due to the better detection of renal lesions; however, despite modern imaging techniques many small renal tumors cannot be classified as benign because they cannot be differentiated from renal cell carcinoma. Ultrasound and computed tomography (CT)-guided kidney biopsy is a safe and accurate method in the diagnostics of renal lesions and can be helpful in the selection of new ablative and pharmaceutical forms of treatment and avoid unnecessary operations...
October 2018: Der Radiologe
Stephen M Korbet, Casey N Gashti, Joni K Evans, William L Whittier
Background: Percutaneous renal biopsy (PRB) of native kidneys (NKs) to better understand and treat acute kidney injury (AKI) is being advocated, but little is known about the risk of complications. Methods: We performed a retrospective study of PRB of NKs in 955 adults from 1991 to 2015 at an academic medical center with real-time ultrasound and automated biopsy needles. Patients undergoing PRB for evaluation of AKI ( n = 160) were compared with 795 patients biopsied for other reasons (not-AKI) for postbiopsy complications [need for transfusion of packed red blood cells (PRBCs), an interventional radiologic or surgical procedure, readmission or death]...
October 2018: Clinical Kidney Journal
Serena M Bagnasco
As rapid progress in science and biotechnology is affecting the practice of renal medicine, increasingly precise diagnostic assessment is needed to select the most effective therapeutic approach for individual patients. The kidney biopsy remains the gold standard for the diagnosis of renal disease, but the field of renal pathology is evolving, classification of renal parenchyma lesions and histopathological diagnostic criteria are undergoing more validation and updates, and new technologies and assays are sought to improve efficiency and accuracy of the diagnostic process...
December 1, 2018: American Journal of Physiology. Renal Physiology
Amanda Cunningham, Hallgrimur Benediktsson, Daniel A Muruve, Ainslie M Hildebrand, Pietro Ravani
Background: Kidney biopsy is considered the gold standard for diagnosis of renal disease. It is increasingly performed in cases of diagnostic uncertainty, including in patients with coexistent diabetes and hypertension, for which a presumptive clinical diagnosis can be made. Little is known about the incidence and distribution of biopsy-proven kidney diseases. Changes in the distribution of biopsy diagnoses over time may have significant implications for resource allocation and future research...
2018: Canadian Journal of Kidney Health and Disease
V Brkovic, M Milinkovic, M Kravljaca, M Lausevic, G Basta-Jovanovic, J Marković-Lipkovski, R Naumovic
Biopsy registries are one of the most important sources of accurate epidemiological data and the clinical presentation of renal diseases. A detailed analysis of clinicopathologic correlations over a period of 20 years (1987-2006) was performed earlier by our centre. The aim of this study was to check the current state and to register possible changes in clinicopathologic findings recorded under better socioeconomical circumstances and new management. Records of 665 renal biopsies performed at our institution were prospectively followed from 2007 to 2014...
October 2018: Pathology, Research and Practice
Sanjeev Sethi, Fernando C Fervenza
A kidney biopsy is done to determine the etiology of the glomerulonephritis (GN) and the severity of the lesion, to identify whether other lesions, related to or not related to the GN, are present on the kidney biopsy and finally to ascertain the extent of chronicity of the GN. The etiology of GN is based on the classification of GN into five groups: immune complex-mediated GN, antineutrophil cytoplasmic antibody (ANCA)-associated GN, anti-glomerular basement membrane (GBM) GN, monoclonal immunoglobulin-mediated GN and C3 glomerulopathy...
August 13, 2018: Nephrology, Dialysis, Transplantation
2018-08-22 09:13:55
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