Renal Disease Diagnosed by Renal Biopsy

Seven patients with petit mal seizures treated with trimethadione, ethadione, or paramethadione for long periods were subjected to renal biopsy at the age of 14½ 16½ years. None of the patients had clinical signs of renal disease at the time of the biopsy, but three of them had previously shown transient hematuria or proteinuria. The renal histology was studied by conventional methods and by electron microscopy, the latter method only including the glomeruli. The changes found must with the present knowledge be regarded as physiological. A short report is given of a patient with phenylketonuria and epilepsy who developed a nephrotic syndrome during treatment with tridione. No definite pathologic renal changes were demonstrated at the when the clinical symptoms had disappeared.

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PERCUTANEOUS RENAL BIOPSY IN CHILDREN

PEDIATRICS ◽

10.1542/peds.30.2.287 ◽

1962 ◽

Vol 30 (2) ◽

pp. 287-296

Author(s):

W. F. Dodge ◽

C. W. Daeschner ◽

J. C. Brennan ◽

H. S. Rosenberg ◽

L. B. Travis ◽

...

Keyword(s):

Renal Disease ◽

Renal Biopsy ◽

Clinical Importance ◽

Renal Diseases ◽

Renal Lesion ◽

Bleeding Tendency ◽

Percutaneous Renal Biopsy ◽

The One ◽

Selection Of

Since 1951, when the percutaneous renal biopsy was introduced as an adjunctive method for study of patients with renal disease, reports of some 4,000 kidney biopsies have appeared in the literature. Only about 250 of these, however, have been performed in children. A biopsy specimen containing 5 to 10 glomeruli has been reported to be adequate for interpretation and to be representative of the total renal parenchyma in 84% of the cases with diffuse renal disease. Using a biopsy technique similar to that described by Kark, we have obtained an adequate specimen in 92% of 205 kidney biopsies performed in 168 children with diffuse renal diseases. Seven deaths have been previously reported in the literature. The circumstances surrounding the death of these seven patients and of the one death that occurred in our series are described. Perirenal hematoma has had a reported incidence of 0.4%. It has been our experience, as well as that of the other investigators, that if blood boss is replaced, the patient has an otherwise uneventful course and the mass subsequently disappears. Gross hematuria has had a reported incidence of 5.2%. Microscopic hematuria, lasting for 6 to 12 hours after biopsy, has been found to be the rule rather than the exception. The complications which have occurred have been associated with bleeding, and therefore a careful history concerning bleeding tendency and a study of the clotting mechanism is essential if the risk of needle renal biopsy is to be minimized. In addition to a bleeding tendency or defect in clotting mechanism, most investigators are agreed that the presence of only one kidney or an uncooperative patient are absolute contraindications to renal biopsy. The renal biopsy is primarily, at present, an additional and most useful investigative tool in the elucidation of the pathogenesis, natural history (by serial studies) and effectiveness of specific therapy upon the various renal diseases. It is of practical clinical importance in the selection of those patients with the nephrotic syndrome in whom glucocorticoid therapy is likely to be beneficial or the patient with anuria whose renal lesion is probably reversible with time; and, as a guide to the effectiveness of therapy in patients with pyelonephritis or lupus nephritis. It is not a technique that can be recommended for general or casual use. A classification of the pathohistobogic findings of diffuse glomerulonephritis, patterned after Ellis, is presented and discussed. This classification will be used in the description and discussion of various renal diseases and systemic diseases with associated nephritis in the three subsequent papers.

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RENAL BIOPSY ANALYSIS OF YOUNG PATIENTS WITH MEDICAL RENAL DISEASE IN A TERTIARY CARE CENTRE HOSPITAL

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2018/1016 ◽

2018 ◽

Vol 7 (42) ◽

pp. 4556-4559

Author(s):

Gupta Hemant R ◽

Varge Nikhil

Keyword(s):

Renal Disease ◽

Renal Biopsy ◽

Tertiary Care ◽

Young Patients ◽

Care Centre ◽

Tertiary Care Centre ◽

Centre Hospital

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Nondiabetic renal disease: a conclusive renal biopsy can overcome diagnosis delay

Journal of The Egyptian Society of Nephrology and Transplantation ◽

10.4103/1110-9165.200352 ◽

2016 ◽

Vol 16 (4) ◽

pp. 144

Author(s):

MohamedO Ezwaie ◽

SaharJ Kharraz ◽

JebrilS Alabidi ◽

AishaA Jazwee

Keyword(s):

Renal Disease ◽

Renal Biopsy ◽

Diagnosis Delay

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

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0114 ◽

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.

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The modern spectrum of biopsy-proven renal disease in Chinese diabetic patients—a retrospective descriptive study

PeerJ ◽

10.7717/peerj.4522 ◽

2018 ◽

Vol 6 ◽

pp. e4522 ◽

Cited By ~ 11

Author(s):

Diankun Liu ◽

Ting Huang ◽

Nan Chen ◽

Gang Xu ◽

Ping Zhang ◽

...

Keyword(s):

Renal Disease ◽

Renal Biopsy ◽

Descriptive Study ◽

Clinical Indication ◽

Diabetic Patients ◽

Tubular Necrosis ◽

Diabetic Renal Disease ◽

Tubulointerstitial Nephropathy ◽

Renal Biopsies ◽

Male Patients

Background Renal biopsies performed in diabetic patients are increasing and becoming more complex. Comprehensive data on modern spectrum of biopsy-proven renal disease in Chinese diabetic patients are lacking. Methods In a nationwide renal biopsy survey including 71,151 native biopsies from 2004 to 2014, diabetic patients were identified according to the clinical diagnosis from referral records. The clinical data were extracted from referral records and pathological reports. Results A total of 1,604 diabetic patients, including 61 patients with T1DM, were analyzed in this study. The median age is 51.39 ± 11.37 years. Male patients accounted for 58% of the population. We found that only 44.7% of diabetic patients had the isolated pathological diagnosis of diabetic nephropathy (DN), while 49.1% had non-diabetic renal disease (NDRD) alone, and 6.2% had NDRD superimposed on DN. Nephrotic syndrome (n = 824, 51.4%) was the most common clinical indication for renal biopsy. Among 887 patients with NDRD, membranous nephropathy (n = 357) was the leading diagnosis, followed by IgA nephropathy (n = 179). Hypertensive renal disease (n = 32), tubulointerstitial nephropathy (n = 27) and acute tubular necrosis (n = 16) accounted for 3.5%, 2.9%, 1.7% of the NDRD cases respectively. Nearly a half (49.2%) of patients with T1DM had NDRD. Discussion Over 55% diabetic patients with kidney disease were diagnosed as non-diabetic renal disease, among which MN and IgAN were the most common two pathological types.

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