Renal biopsy

Specimen:

Percutaneous needle biopsy or open surgical biopsy. 

FNAB (mass lesions). 

Renal biopsies require special collection procedures and should be done only in centres with appropriate facilities and after consultation with laboratory staff.

Method:

Fresh tissue: for Immunofluorescence and for Molecular genetics of some renal tumours.

Fixed tissue: for light microscopy (some laboratories use special fixatives), Immunohistochemistry and Electron microscopy (special fixative).

Application:

Acute renal failure; 

glomerular haematuria; 

some cases of Nephrotic syndrome and isolated proteinuria; 

assessment of renal involvement in systemic disease;

suspected renal neoplasm; and

following renal transplantation to distinguish rejection from other causes of deterioration in renal function.

Interpretation:

Categorisation of glomerulonephritis and other glomerulopathies (eg, Diabetes mellitus, amyloid, hereditary renal disease), interstitial nephritis and renal vascular disease.

Monitoring transplant rejection.

Diagnosis of drug toxicity and systemic disease affecting the kidneys (eg, Vasculitis).

Identification of tumour type and grade.

Reference:

Zhou XJ et al. Silva's Diagnostic Renal Pathology. 1st ed. 2009. Cambridge.