In their initial report in 1951, Iverson and Brun described localization of the lower pole of the right kidney using intravenous pyelography and a lead mark on the skin
The result of the biopsy altered management in 86% of cases of nephrotic range proteinuria, 71% of cases of ARF, 45% of cases of CRF, 32% of cases with haematuria and proteinuria, 12% of cases with non-nephrotic proteinuria alone, and 3% of cases with haematuria alone.
Mean decsease in Hb after bx is 1g/dl. Transient microscopic hematuria is detected in all cases.
Incidence is 0.8-1% and is seen in post transplant kidney biopsies
The purpose of fixation is to preserve tissues permanently in as life-like a state as possible. Fixation should be carried out as soon as possible after removal of the tissues (in the case of surgical pathology) or soon after death (with autopsy) to prevent autolysis. Aldehydes include formaldehyde (formalin) and glutaraldehyde. Tissue is fixed by cross-linkages formed in the proteins, particularly between lysine residues. This cross-linkage does not harm the structure of proteins greatly, so that antigenicity is not lost. Therefore, formaldehyde is good for immunoperoxidase techniques
A product called paraplast contains added plasticizers that make the paraffin blocks easier for some technicians to cut.
IgA shows clumped staining with a branching, polygonal pattern typical of mesangial immune complex deposition. IgG shows bright, finely granular staining of capillary loop basement membranes, indicating the presence of capillary loop immune complex deposits
Positive stains deposit electron dense material on the area of interest, so that it stands out as a dark area on a light background. Negative stains penetrate and darken the interstices between areas of interest, which then appear light on a dark background.
RENAL BIOPSY DR. VISHAL GOLAY 28-10-10 DM Seminar
276 native renal biopsies; management was altered in 42% of cases overall. Nephrol Dial Transplant. 1994;9(9):1255-9
3 year prospective study involving 80 patients; Pre-biopsy predicted histologic diagnosis was changed in 44% of the patients as a result of the biopsy. Prognosis changed in 57% of the patients. Therapy changed in 31% of the patients. Clin Nephrol. 1986 Nov;26(5):217-21
111 renal biopsies in childern; biopsy altered diagnosis in 24.5%. Post biopsy, treatment was changed in 22.6%. 18.9% had a change in both the diagnosis and treatment. Zhonghua Min Guo. 1998 Jan-Feb;39(1):43-7
In one study of 101 biopsies nephrologists used a portable ultrasound machine for location and depth of the kidney. The results are similar to those of previous studies using automatic devices but under direct ultrasound guidance.
Page kidney : compression of kidney by a hematoma leads to high renin hypertension. It is believed to result from microvascular ischemia and alteration of small-vessel hemodynamics from external compression.
750 biopsies; Complications were identified 42% patients by 4 h, in 67% patients by 8 h, in 85% patients by 12 h, and in 89% patients at 24 h. After biopsy, an observation time of up to 24 h remains optimal.
J Am Soc Nephrol 15:142-147, 2004
Maya and Allon et al; 100 renal biopsies. 8 hour observation is safe.