Clinical Utility of Kidney Biopsies in the Diagnosis and Management of Renal Disease

Abstract

A prospective study was undertaken to assess the utility of the renal biopsy as a tool in the clinical practice of nephrology. Nephrologists performing this procedure were surveyed concerning prebiopsy diagnosis, plans for therapy and estimation of prognosis, before and after biopsy results were disclosed. On the basis of 108 specimens from both academic centers and community hospitals, clinical and pathological diagnoses differed in 63 % and therapeutic approach was altered in 34% of the cases. These results were greatest for nephrotic syndrome and for renal failure of rapid onset. The change in treatment was frequently of major consequence: decisions for the use of corticosteroids, cytotoxic agents and/or plasma exchange were altered based upon biopsy diagnoses. There were no differences either in diagnostic acumen or therapeutic approach between academic and community nephrologists. We conclude that renal biopsies are an important and frequently used part of the nephrologists’ approach to patient care.

GC/TOFMS analysis of metabolites in serum and urine reveals metabolic perturbation of TCA cycle in db/db mice involved in diabetic nephropathy

“…3. Among the six organic acids measured in the urine, the ketobody, 3-hydroxybutyrate was higher in the db/db mice at weeks 6,8,10,12, and 16, whereas the others were generally lower than in the control mice.…”

“…However, studies have suggested that microalbuminuria is neither a sensitive nor a specific predictor of DN (28). Clinically, renal biopsies are often conducted to confirm the final pathological diagnosis (6,21). Although renal biopsy has generally been accepted as a useful approach to nephrological diagnoses, its invasiveness, potential damage, and complications (including hematuria, perirenal hematoma, and infection) greatly reduce its application.…”

Renal biopsy: Still a landmark for the nephrologist

“…The indications uniformly recognized by most nephrologists are represented by nephritic and/or nephrotic syndrome and unexplained acute or rapidly progressive renal failure [1] . Primary glomerulonephritis are the more common renal disease in renal biopsy registries.…”

Perfil das doenças glomerulares em um hospital público do Distrito Federal

“…7,8 In Brazil, as in several other countries, glomerular diseases are a frequent etiology of chronic kidney failure, 9,10 and kidney biopsy plays a fundamental role in the correct histopathological and etiological diagnosis and even in the prognosis of such cases. 11,12 Glomerular diseases often have an insidious and asymptomatic course, which determines diagnostic delay, contributing to a poorer kidney and patient's clinical survival. 13 Epidemiological studies of glomerular diseases, even when conducted regionally, are important because they contribute to better understanding the incidence of those pathologies and allow the adoption of differentiated strategies aiming at new forms of prevention and treatment.…”