Renal biopsy seminar
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Presentation on the various aspects of renal biopsy Author: Vishal Golay, DM trainee in Nephrology, IPGMER, Kolkata
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Renal biopsy seminar
- 1. RENAL BIOPSY DR. VISHAL GOLAY 28-10-10 DM Seminar
- 12. Biopsy gun
- 16. Procedure
- 17. Procedure
- 23. Complications of renal biopsy Ateriovenous fistula-post biopsy
- 40. IgG IgA Idiopathic MGN IgA Nephropathy
- 46. Reporting a Renal Biopsy
- 47. Reporting a Renal Biopsy
- 48. Reporting a Renal Biopsy
- 49. Reporting a Renal Biopsy
- 56. Sushmita Das (SLE Class IV) Wire loops
- 57. Cellular crescent Fibrinoid necrosis Global proliferation with neutrophilic infiltration
- 60. Amal Panja (Crescentic GN)
- 61. Sabita Majumdar (Pauci-immune CrGN)
- 62. Sukumar Bodhak (IgA Nephropathy) IgA
Editor's Notes
- 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.