Interpretation of Renal Biopsies in IgA Nephropathy

2007 ◽  
pp. 44-49 ◽  
Author(s):  
H. Terence Cook
Keyword(s):  
Iga Nephropathy ◽  
Renal Biopsies

scholarly journals P0114BENEFITS AND CHALLENGES OF A RENAL BIOPSY REGISTRY AND NETWORK - FCGG EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Wim Laurens ◽  
Johan De Meester ◽  
Ben Sprangers ◽  
Steven Van Laecke ◽  
Dendooven Amélie ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Clinical Care ◽  
Adult Population ◽  
Age Groups ◽  
Time Frame ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Renal Biopsies

Abstract Background and Aims End December 2016, a renal biopsy network in the Flemish region (Belgium) was founded as a collaboration between the renal pathologists and nephrologists. This FCGG network introduced a uniform renal biopsy request form, a well-structured report form of the renal pathology examination and a comprehensive list of renal pathology diagnoses. Method Following informed consent [99.5%] and in compliance with GDPR, the registration of the renal biopsies consists of basic categorical renal data, structured renal pathology information and the final clinical renal disease. Results In 2017 and 2018, 1385 renal biopsies were registered – 10.5 per million inhabitants per year; in addition, 28 patients had a repeat biopsy in the same time frame (2%). Of the pediatric patients ( age < 18 years; N=92; 6.6%), 23 had IgA nephropathy, 20 a minimal change disease and 15 another type of glomerulonephritis. The biopsy was reported as normal or non-diagnostic in 15 patients (16%) – the majority was clinically considered as glomerulonephritis. The spectrum of the adult population was quite similar across gender and age groups: 56% glomerulonephritis [= IgA nephropathy [19%] + FSGS [8%] + pauci-immune glomerulonephritis [7%] + other GN [22%] ), 10% tubulo-interstitial nephritis, 7% acute tubular necrosis [ATN], 7% diabetes mellitus, and 7% nephroangiosclerosis. Exceptions are pauci-immune glomerulonephritis as the most important renal disease in women aged 65 years and older, and lupus nephritis as the second most important glomerulonephritis in women aged 18-44 years. Only a small percentage of adult renal biopsies yielded no result (7%), clinically interpreted as glomerulonephritis in 50% of the cases. Conclusion The FCGG network has provided a more intense collaboration between renal pathologists and nephrologists mainly by standardizing the renal biopsy reading and reporting across all centers. More precise estimates of the prevalent renal diseases were provided for the first time; however, in order to get full information, renal diseases diagnosed by other techniques ( serology, genetic analysis ) should also be collected in the future. Efforts will be done to coordinate the clinical care of renal diseases, particularly the more rare renal diseases, and to offer access to new therapeutic molecules or new schemes, through this super-regional network.

scholarly journals Inebriated liver causing mesangial turmoil

2021 ◽  
Vol 11 (1) ◽  
pp. 5-6
Author(s):  
Luis Caraballo
Keyword(s):  
United States ◽  
Liver Cirrhosis ◽  
Iga Nephropathy ◽  
Unusual Case ◽  
The United States ◽  
Glomerular Disease ◽  
Renal Biopsies ◽  
Glomerular Lesions ◽  
Primary Glomerular Disease ◽  
The Relationship

IgA nephropathy is the most common primary glomerular disease worldwide, diagnosed 10% of renal biopsies in the United States, up to 20% in Europe and approximately 40% in Asia, the latter being the leading cause of ESRD in Asia. Multiple studies have shown the relationship between cirrhosis and the development of glomerular lesions leading IgA deposition in the mesangium causing IgAN. Here we present an unusual case of a 64-year-old female presenting with IgA nephropathy induced by liver cirrhosis.

scholarly journals P0134PROTEINURIA IS NOT ALWAYS ASSOCIATED WITH PROGNOSIS IN IGA NEPHROPATHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Byoung-Soo Cho ◽  
Hyaejin Yun ◽  
Sungmin Jung ◽  
Hyun-soon Lee
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Surrogate Marker ◽  
Pulse Therapy ◽  
Methylprednisolone Pulse Therapy ◽  
Renal Pathology ◽  
Crescent Formation ◽  
Methylprednisolone Pulse ◽  
Renal Biopsies

Abstract Background and Aims To date the most widely well studied risk factor for progression to ESRD in patients with IgA nephropathy is proteinuria. Recent report suggests proteinuria reduction as a surrogate end point in trial of IgA nephropathy(2019,CJASN). Sensitivity of most biomarkers such as blood and urine gd-IgA1 level, IgG/IgA autoantibody, sCD89, sCD71, NGAL, KIM-1, Cystatin-C etc were compared with the amount of proteinuria. Most nephrologists do not performing kidney biopsy in patients without proteinuria or proteinuria less than than 500mg/day even though IgA nephropathy is suspected. However we recently experienced severe IgA nephropathy (HSD Lee, grade IV) in patients with normal urinalysis, and more than half the patients showed stationary or aggravated renal pathology at the follow up renal biopsy although urinalysis findings were normalized after methylprednisolone pulse therapy. Method In our center we performed 892 renal biopsies during last 6 years, we experienced 253 IgA nephropathy, of which 152 cases were done follow up renal biopsies to see the pathologic changes who showed normalized urinalysis findings after methylprednisolone pulse therapy. Results Of the 253 patients 241 patients showed initial abnormal urinalysis like hematuria and or proteinuria. However eleven patients showed normal urinalysis at the time of renal biopsy, of which 5 cases were diagnosed as essential hypertension and 6 cases were normal urinalysis associated with lowered GFR. Of the 152 follow up renal biopsies we evaluated 99 cases who showed normalized urinalysis findings after therapy, of which 65 cases(65.7%) showed stationary or aggravated renal pathology. Conclusion In conclusion further long term studies are needed, proteinuria could not be a surrogate marker for prognosis of the IgA nephropathy, Regardless of proteinuria if associated with hypertension and or lowered GFR, renal biopsy should be done. Follow up renal biopsy might be needed to confirm the healing of IgA nephropathy regardless of urinary findings to see the disappearance of IgA deposition, decreasing mesangial and endocapillary hypercellularity, disappearance of crescent formation, decreasing sclerosis, etc.

scholarly journals Formalin-fixed paraffin-embedded renal biopsy tissues: an underexploited biospecimen resource for gene expression profiling in IgA nephropathy

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Sharon Natasha Cox ◽  
Samantha Chiurlia ◽  
Chiara Divella ◽  
Michele Rossini ◽  
Grazia Serino ◽  
...  
Keyword(s):  
Gene Expression ◽  
Iga Nephropathy ◽  
Clinical Decision Making ◽  
Expression Profiles ◽  
Specific Gene ◽  
Renal Lesions ◽  
Formalin Fixed Paraffin ◽  
Renal Biopsies ◽  
Formalin Fixed Paraffin Embedded ◽  
Formalin Fixed

Abstract Primary IgA nephropathy (IgAN) diagnosis is based on IgA-dominant glomerular deposits and histological scoring is done on formalin-fixed paraffin embedded tissue (FFPE) sections using the Oxford classification. Our aim was to use this underexploited resource to extract RNA and identify genes that characterize active (endocapillary–extracapillary proliferations) and chronic (tubulo-interstitial) renal lesions in total renal cortex. RNA was extracted from archival FFPE renal biopsies of 52 IgAN patients, 22 non-IgAN and normal renal tissue of 7 kidney living donors (KLD) as controls. Genome-wide gene expression profiles were obtained and biomarker identification was carried out comparing gene expression signatures a subset of IgAN patients with active (N = 8), and chronic (N = 12) renal lesions versus non-IgAN and KLD. Bioinformatic analysis identified transcripts for active (DEFA4,TNFAIP6,FAR2) and chronic (LTB,CXCL6, ITGAX) renal lesions that were validated by RT-PCR and IHC. Finally, two of them (TNFAIP6 for active and CXCL6 for chronic) were confirmed in the urine of an independent cohort of IgAN patients compared with non-IgAN patients and controls. We have integrated transcriptomics with histomorphological scores, identified specific gene expression changes using the invaluable repository of archival renal biopsies and discovered two urinary biomarkers that may be used for specific clinical decision making.

scholarly journals Changes in the glomerular density and size in serial renal biopsies during the progression of IgA nephropathy

2008 ◽  
Vol 24 (3) ◽  
pp. 892-899 ◽  
Author(s):  
Nobuo Tsuboi ◽  
Tetsuya Kawamura ◽  
Takeo Ishii ◽  
Yasunori Utsunomiya ◽  
Tatsuo Hosoya
Keyword(s):  
Iga Nephropathy ◽  
Renal Biopsies

Positive and negative hepatitis B virus in renal biopsies of IgA nephropathy: an 85-case clinicopathological analysis

Nephrology ◽  
2001 ◽  
Vol 6 (4) ◽  
pp. 185-189 ◽  
Author(s):  
Zhao-Long Wu ◽  
Nian-Song Wang ◽  
Xun-Hui Xu ◽  
Lian-Qun Qiu ◽  
Qin ZHOU1 ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Iga Nephropathy ◽  
Clinicopathological Analysis ◽  
B Virus ◽  
Renal Biopsies

T-cell receptor repertoire in IgA nephropathy renal biopsies

Nephrology ◽  
2002 ◽  
Vol 7 ◽  
pp. S114-S121
Author(s):  
John F Knight ◽  
Anthony R Clarkson ◽  
Huiling Wu
Keyword(s):  
T Cell ◽  
Iga Nephropathy ◽  
T Cell Receptor ◽  
Cell Receptor ◽  
Receptor Repertoire ◽  
Renal Biopsies ◽  
T Cell Receptor Repertoire ◽  
Cell Receptor Repertoire

scholarly journals P0102A REVIEW OF RENAL BIOPSIES IN A LARGE UK RENAL CENTRE- A 20 YEAR EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Amy Hudson ◽  
Smeeta Sinha
Keyword(s):  
Iga Nephropathy ◽  
Tissue Type ◽  
Diagnostic Modality ◽  
Tissue Samples ◽  
Patient Demographics ◽  
Thin Basement Membrane Disease ◽  
Renal Biopsies ◽  
Classification Of Diseases ◽  
Biopsy Report

Abstract Background and Aims Percutaneous renal biopsy is the mainstay of renal pathological diagnosis. Not only does it secure an accurate diagnosis, but also lends itself to guiding the prognosis of a myriad of renal disorders. An important diagnostic modality for nephrologists, they have contributed greatly to the field of nephrology, both in terms of the classification of diseases and assisting in understanding their pathogenesis. Adequacy of the tissue samples of at least ten to fifteen glomeruli is generally preferred. The aim of our retrospective study was to review the renal biopsies done in one large UK renal centre, namely Salford Royal Foundation Trust, over the last twenty years. This Trust covers a catchment area that serves approximately 1.5 million people. Method A list of all renal biopsies performed at Salford Royal Foundation Trust between January 2000 to January 2020 was generated by our pathology department. Following this, each individual biopsy report was reviewed. In addition to this, certain information was collated from individual patient records; namely patient demographics, the indication for biopsy, tissue type (native or transplant), histological diagnosis and outcomes. Our centre has an excellent electronic patient record (EPR). This enabled us to analyse full clinical data retrospectively for each case. Results Between January 2000 and January 2020 a total of 3555 renal biopsies were performed at Salford Royal Foundation Trust. These biopsies were performed solely by nephrology specialists and supervised trainees, under ultrasound guidance. 177.5 biopsies were performed on average, per year, ranging between 140 – 203. 90% of biopsies were performed on native kidneys, with 10% being performed on transplanted kidneys. 10% of biopsies had normal histology morphologically when reviewed by light microscopy. There diagnoses of these included entities minimal change disease and thin basement membrane disease most commonly. IgA nephropathy was the most common glomerular pathology identified, in keeping with the wealth of published literature. There were over 525 biopsies done confirming IgAN as the primary pathology. 7% of biopsies had a crescentic glomerular pathology when examined histologically. The main causes included crescentic IgA nephropathy and anca-associated vasculitis. Conclusion Kidney biopsies have long been regarded as safe, minimally invasive procedures are of paramount importance to our diagnostic armamentarium. Our data echoes that of already published pathology series, IgAN being the most common glomerular pathology in our series. We further plan to analyse the various conditions and their outcomes in further detail.

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