Is renal biopsy necessary for optimal management of the idiopathic nephrotic syndrome?

Kassirer, Jerome P.

doi:10.1038/ki.1983.194

Cited by 37 publications

(14 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Gault and Muehrcke [2], in a com prehensive review, have presented indications and con troversies for the use and value of biopsies. In contrast to Kassirer [ 15] and Levey et al [ 10], they and others advo cate their use in adult nephrotic syndrome [16,17] and in certain well-defined instances in children [18]. In par ticular, we have demonstrated that it is clearly not possi ble to predict the type of glomerular lesion responsible for nephrotic-range proteinuria in adults; the conse quence of this is that corticosteroid therapy cannot be administered intelligently without biopsy diagnosis.…”

Section: Discussionmentioning

confidence: 58%

“…Although many nephrologists and pathologists have traditionally concurred that renal biopsies have clinical value, this view has recently been challenged [6][7][8][9]14], Kassirer [ 15] and others [ 10] have questioned the need for biopsy in adults with 'idiopathic nephrotic syn drome'. Danovitch and Nissenson [9], among others, have generally agreed that renal biopsy is an important part of the evaluation of nephrotic syndrome; however, they expressed skepticism about its value for isolated nonnephrotic proteinuria, hematuria with or without proteinuria, diabetic patients with an apparently 'typi cal' course of renal disease and some patients with acute or chronic renal failure.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

et al. 1989

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

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

et al. 1989

View full text Add to dashboard Cite

show abstract

“…The model developed, and the data used to populate the model, are largely based on previous studies by Levey and colleagues 58 and Kassirer 57 (both of which address research questions over biopsytailored treatment).…”

Section: Figure 4 Decision Tree For Therapy For Idiopathic Membranousmentioning

confidence: 99%

“…The model developed by Levey and colleagues 58 was based on the earlier study by Kassirer,57 but it was further informed by a more extensive review of the literature and further analysis of available data, to inform both parameter values and model structure.…”

Section: Figure 4 Decision Tree For Therapy For Idiopathic Membranousmentioning

confidence: 99%

“…None of these studies included cost data in their analyses. Four studies present evaluations of the practice of biopsy prior to steroid treatment for nephrotic syndrome in adults [56][57][58] and children. 59 One study 60 considers use of prophylactic oral anticoagulation in nephrotic patients with idiopathic membranous nephropathy.…”

Section: Evidence On the Modelling Of Disease Progression In Patientsmentioning

confidence: 99%

See 1 more Smart Citation

The clinical effectiveness and cost-effectiveness of treatments for children with idiopathic steroid-resistant nephrotic syndrome: a systematic review

Colquitt¹,

Kirby²,

Green³

et al. 2007

Health Technol Assess

View full text Add to dashboard Cite

Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTAThe clinical effectiveness and cost-effectiveness of treatments for children with idiopathic steroid-resistant nephrotic syndrome: a systematic review NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissione...

show abstract

The nephrotic syndrome in the elderly: clinico-pathological correlations in 317 patients

Johnston

Brown

Davison

1992

Geriatric Nephrol Urol

View full text Add to dashboard Cite

Is renal biopsy necessary for optimal management of the idiopathic nephrotic syndrome?

Cited by 37 publications

References 49 publications

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

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

The clinical effectiveness and cost-effectiveness of treatments for children with idiopathic steroid-resistant nephrotic syndrome: a systematic review

The nephrotic syndrome in the elderly: clinico-pathological correlations in 317 patients

Contact Info

Product

Resources

About