Nierenbiopsie: Indikation und Durchführung

Gerth, Jens; Wolf, Günter

doi:10.1007/s11560-008-0165-8

Cited by 5 publications

(2 citation statements)

References 31 publications

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“…It was consequently concluded that structural abnormalities of the monoclonal molecules are responsible for the specific forms of renal manifestation [9][10][11][12] . Although modern biopsy techniques such as ultrasound guidance and semiautomatic biopsy guns have been established, the risk of bleeding exists in MM because thrombocytopenia is frequently present, and abnormalities of the coagulation system exist due to the nephrotic syndrome and high levels of paraproteins [13] .…”

mentioning

confidence: 99%

Screening and Differential Diagnosis of Renal Light Chain-Associated Diseases

Gerth¹,

Sachse

Busch

et al. 2011

Kidney Blood Press Res

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Background: Renal involvement in the light chain-associated diseases multiple myeloma (MM), amyloidosis (AL) and monoclonal immune position disease (MIDD) is common and differential diagnosis usually requires renal biopsy. The aim of this study was to investigate if noninvasive methods are viable to identify and differentiate between the various types of kidney diseases. Patients and Methods: All patients with a light chain-associated disease admitted to our center from 1996 to 2008 were retrospectively evaluated. Renal biopsy data were correlated with proteinuria findings. Results: Only the ratio of free ĸ/λ light chains showed a good sensitivity for myeloma cast nephropathy (MCN), AL and MIDD. The λ light chain was characteristic for AL, the ĸ light chain dominated in MIDD. Renal function at the time of diagnosis was worst in MIDD. MCN presented with a proteinuria of >3.5 g/g creatinine. In contrast, a higher proteinuria was found in AL or MIDD. Whereas the ĸ/λ ratio in the urine was pathological for all three diseases, extremely high or low ratios indicated the presence of MCN. However, in AL or MIDD, the ratio was only moderately elevated. Conclusion: A noninvasive differentiation between MCN and other forms of renal light chain disease is possible.

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confidence: 99%

Screening and Differential Diagnosis of Renal Light Chain-Associated Diseases

Gerth¹,

Sachse

Busch

et al. 2011

Kidney Blood Press Res

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“…Kidney biopsy is a main useful diagnostic procedure in nephrology [ 1 ]. In cases where percutaneous renal biopsies (PRBs) cannot be performed, only open kidney biopsy was frequently applied in the past [ 2 ]. In 1990, the interventional–radiological technique of transvascular liver biopsy was adapted for transvascular renal biopsies (TRBs) [ 3 ].…”

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confidence: 99%