Role of renal biopsy in managing pediatric renal diseases: A midterm analysis of a series at bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

Renal biopsy tissues were taken from 142 suspected glomerulonephritic patients who were admitted into the Department of Nephrology of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Combined Military Hospital (CMH), Dhaka Cantonment, Dhaka. The tissues were processed for both Light Microscopy (LM) and Direct Immunofluorescence (DIF) studies. The study was done in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka and Armed Forces Institute of Pathology (AFIP), Dhaka Cantonment, Dhaka, from March to December 1999. Seven histopathological types of glomerulonephritis were identified with LM and another one type i.e. IgA Nephropathy was identified exclusively by using DIF. Diffuse immunofluorescence positivity was found in 44.36% cases. C3 components were found in all cases irrespective of the histopathological type of glomerulonephritis. Immune complex deposits were observed in immunofluorescence both in the mesangium and the glomerular basement membrane (GBM) with more generalized and less scattered distributions. Immunoglobulins (Ig) were tested for IgG, IgA and IgM. IgG was found the most common (74.60%) among immune complex deposits. Notable LM features include proliferation of mesangial cells, expansion of mesangial matrix, thickening of GBM, infiltration of glomerular macrophages, platelets and neutrophil and crescent formation. The presence of IgG in the mesangium of the kidney of the glomerulonephritic patient suggests a role of IgG in the inflammatory process. There is also evidence that C3 is synthesized within the glomeruli of the patients with glomerulonephritis. Finding the role of the complement components in pathogenesis of glomerulonephritis, a keen observation is needed to determine the extent of local complement synthesis and their involvement in tissue injury process. Key words: Complement synthesis; immune complex; glomerulonephritis; renal biopsy. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8566 J Dhaka Med Coll. 2011; 20(1) : 15-19

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Approach to native medical renal biopsy interpretation of glomerular disease

Journal of Pathology of Nepal ◽

10.3126/jpn.v9i2.25664 ◽

2019 ◽

Vol 9 (2) ◽

pp. 1571-1579

Author(s):

Gopi Aryal ◽

Sameer Chhetri Aryal

Keyword(s):

Renal Biopsy ◽

Renal Tissue ◽

Clinical Syndrome ◽

Renal Diseases ◽

Primary Role ◽

Pathology Laboratory ◽

Glomerular Diseases ◽

Clinical Presentations ◽

Biopsy Interpretation

Diverse pathogenetic mechanisms and clinical manifestation of renal diseases may produce the same renal morphologic pattern or variety of renal morphologic pattern can lead to the same clinical syndrome. The primary role of the renal biopsy is to provide a diagnosis and information about disease activity and chronicity. The systematic approach to native medical renal biopsy includes evaluation of the four compartments of the kidney sequentially (glomeruli, tubules, interstitium, and blood vessels). The diagnosis in renal pathology is an integrated process in which we must analyze all clinical data, light microscopy, immunohistology, and electron microscopy studies for diagnosis. The aim of the article is to describe the handling of the renal tissue in the anatomical pathology laboratory. It also provides the guideline to renal biopsy evaluation and approach to arrive at the diagnosis of glomerular diseases with similar clinical presentations.

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The nature and prognosis of renal diseases in chronic hepatitis-C-infected diabetic Egyptian patients: The role of renal biopsy

Diabetes & Metabolic Syndrome Clinical Research & Reviews ◽

10.1016/j.dsx.2021.102368 ◽

2021 ◽

pp. 102368

Author(s):

Emad Samaan ◽

Shahera El-Etreby ◽

Aimun Ahmed ◽

Fatma El-Husseini ◽

Alaa Sabry

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Renal Biopsy ◽

Chronic Hepatitis C ◽

Renal Diseases ◽

Egyptian Patients

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P0415MONOCLONAL GAMMOPATHY-RELATED RENAL DISEASES: NEW CLINICAL AND HISTOLOGICAL PATTERNS

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa142.p0415 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Giulia Schiavone ◽

Marisa Santostefano ◽

Benedetta Fabbrizio ◽

Elena Mancini

Keyword(s):

Renal Biopsy ◽

Light Chain ◽

Monoclonal Gammopathy ◽

Kidney Tissue ◽

Renal Diseases ◽

Type I ◽

Diagnostic Challenge ◽

Cytoplasmic Inclusions ◽

Ckd Stage

Abstract Background and Aims In the last few years new clinical-histopathological forms of paraproteinemia associated kidney disease have emerged: light chain proximal tubulopathies, proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) and C3-glomerulopathy. It is now widely recognized that the pathogenic role of the monoclonal protein depends on the free light chain chemical-physical features, even in the case of “dangerous small B cell clones”. Thus MGRS (monoclonal gammopathy of renal significance) associated disease is now considered a different entity from monoclonal gammopathy of undetermined significance (MGUS). Method We retrospectively evaluated the clinical-histopathological features of the biopsies performed in our Nephrological Unit on patients with MGUS in 2008-2018, in order to re-classify them in accordance with the recent scientific literature. Results Nine patients (7 M/2 F; age 46-77 y) were analyzed: five of them suffering from CKD stage 2, four of them with AKI or rapidly progressive CKD, 7 with proteinuria > 1 g/day, 2 with physiological proteinuria. Bone marrow biopsy: 7 patients with MGUS, 2 with smoldering multiple myeloma. Renal biopsy: 4 glomerulopathies (monoclonal fibrillary glomerulonephritis, cryoglobulinaemic (type I) glomerulonephritis, C3 glomerulonephritis, PGNMID), 5 proximal tubulopathies (2 LCPT with Fanconi syndrome, 1 LCPT without cytoplasmic inclusions and with interstitial inflammatory reaction, 2 LCPT with acute tubular necrosis) Table 1, Table 2, Light microscopy and IF of PGNMID. Conclusion MGRS is responsible for the pathogenesis of new histopathological renal lesions, based on new pathogenetic pathways. The clinical and histological features of the different disease states are dependent on the structure of FLCs. Our retrospective analysis of MGRS biopsies confirms how difficult and complex the diagnostic challenge of monoclonal renal injury really is. The differentiation between MGUS and MGRS is based on renal biopsy and demonstration of monoclonality on kidney tissue even if serum/urine immunofixation is negative. Early biomarkers of the pathogenetic role of monoclonal FLC should be identified both for diagnosis and therapeutical monitoring.

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The Role of Cannabinoid Receptors in Renal Diseases

Current Medicinal Chemistry ◽

10.2174/0929867324666170911170020 ◽

2018 ◽

Vol 25 (7) ◽

pp. 793-801 ◽

Cited By ~ 6

Author(s):

Helene Francois ◽

Lola Lecru

Keyword(s):

Cannabinoid Receptors ◽

Renal Diseases

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Safety of Renal Biopsy by Physicians with Short Nephrology Experience

Healthcare ◽

10.3390/healthcare9040474 ◽

2021 ◽

Vol 9 (4) ◽

pp. 474

Author(s):

Kenta Torigoe ◽

Kumiko Muta ◽

Kiyokazu Tsuji ◽

Ayuko Yamashita ◽

Shinichi Abe ◽

...

Keyword(s):

Renal Artery ◽

Renal Biopsy ◽

Renal Diseases ◽

Complication Rates ◽

Artery Embolization ◽

Clinical Nephrology ◽

Percutaneous Renal Biopsy ◽

Artery Embolism ◽

Renal Artery Embolization ◽

Biopsy Complications

Percutaneous renal biopsy is an essential tool for diagnosing various renal diseases; however, little is known about whether renal biopsy performed by physicians with short nephrology experience is safe in Japan. This study included 238 patients who underwent percutaneous renal biopsy between April 2017 and September 2020. We retrospectively analyzed the frequency of post-renal biopsy complications (hemoglobin decrease of ≥10%, hypotension, blood transfusion, renal artery embolization, nephrectomy and death) and compared their incidence among physicians with varied experience in nephrology. After renal biopsy, a hemoglobin decrease of ≥10%, hypotension and transfusion occurred in 13.1%, 3.8% and 0.8% of patients, respectively. There were no cases of post-biopsy renal artery embolism, nephrectomy, or death. The composite complication rate was 16.0%. The incidence of post-biopsy complications was similar between physicians with ≥3 years and <3 years of clinical nephrology experience (12.5% vs. 16.8%, p = 0.64). Furthermore, the post-biopsy composite complication rates were similar between physicians with ≥6 months and <6 months of clinical nephrology experience (16.3% vs. 15.6%, p > 0.99). Under attending nephrologist supervision, a physician with short clinical nephrology experience can safely perform renal biopsy.

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Kinins and Kinin Receptors in Cardiovascular and Renal Diseases

Pharmaceuticals ◽

10.3390/ph14030240 ◽

2021 ◽

Vol 14 (3) ◽

pp. 240

Author(s):

Jean-Pierre Girolami ◽

Nadine Bouby ◽

Christine Richer-Giudicelli ◽

Francois Alhenc-Gelas

Keyword(s):

Experimental Studies ◽

Physiological Role ◽

Renal Diseases ◽

Kinin System ◽

Genetic Studies ◽

Pharmacological Manipulation ◽

Kininase Ii ◽

Kinin Receptors ◽

Kallikrein Kinin System

This review addresses the physiological role of the kallikrein–kinin system in arteries, heart and kidney and the consequences of kallikrein and kinin actions in diseases affecting these organs, especially ischemic and diabetic diseases. Emphasis is put on pharmacological and genetic studies targeting kallikrein; ACE/kininase II; and the two kinin receptors, B1 (B1R) and B2 (B2R), distinguished through the work of Domenico Regoli and his collaborators. Potential therapeutic interest and limitations of the pharmacological manipulation of B1R or B2R activity in cardiovascular and renal diseases are discussed. This discussion addresses either the activation or inhibition of these receptors, based on recent clinical and experimental studies.

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Healthy Ageing and Vaccines: Application of the P4 Medicine Concept to Immunizations

Gerontology ◽

10.1159/000517211 ◽

2021 ◽

pp. 1-7

Author(s):

Jean-Pierre Michel ◽

Fiona Ecarnot

Keyword(s):

Life Course ◽

Health Care Professionals ◽

Personal Autonomy ◽

Scientific Evidence ◽

Functional Decline ◽

Healthy Ageing ◽

Renal Diseases ◽

P4 Medicine ◽

Community Protection

In today’s tormented world, it appears useful to take advantage of communication channels to promote life-course immunization and affirm its major role in healthy ageing. Instead of developing the argument of chronological age, we demonstrate the life-course principle here based on the P4 medicine concept. Are vaccines “preventive, personalized, predictive, and participatory?” Based on detailed analysis of research findings, we successively demonstrate the seminal role of vaccines on preventable infectious diseases, post-sepsis functional decline, non-communicable diseases (cardio-neuro-vascular, respiratory, and renal diseases), community protection, antimicrobial resistance, and perhaps even old-age dementia. Healthy ageing and the promotion of immunization are closely dependent on health literacy and provision of information by skilled health-care professionals. However, personal autonomy and individual freedom are influenced by psycho-cognitive hurdles (cultural approaches, beliefs, emotions, and behaviours), the opinions of the public/family/friends, and the increasing role of social media, which challenges scientific evidence. A similar phenomenon exists when dealing with the issue of healthy ageing, whose success depends greatly on life-course immunization.

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