Renal Biopsy, Light Microscopy
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Kidney biopsy has proven to be of value in the clinical evaluation and management of patients with undiagnosed kidney disease. The clinical setting may include acute renal failure, nephrotic syndrome, asymptomatic proteinuria and hematuria. Kidney diseases in the setting of a systemic disease are often diagnosed on kidney biopsy.
Biopsy of the transplanted kidney is important in the determination of the presence of acute rejection, infection, or recurrent disease.
Optimal interpretation of a kidney biopsy requires integration of clinical and laboratory results with light microscopic, immunofluorescent histology, and electron microscopy findings.
Tissue should always be submitted for evaluation by light microscopy. In some instances, electron microscopy is required (eg, Alport's syndrome, dense deposit disease, minimal change nephropathy, thin basement membrane disease, etc.) to make an accurate diagnosis and submission of tissue for immunofluorescent histology is required to evaluate for immune complex mediated disease.
We recommend that additional material be submitted for evaluation by immunohistologic method.
The evaluation of patients with undiagnosed kidney disease
Following the progression of disease or response to therapy
Determining the cause of dysfunction in the transplanted kidney (allograft)
A verbal report is given by phone upon completion of the light microscopic examination.
A written report is subsequently issued along with histologic slides, and will incorporate results of immunfluorescent histology and/or electron microscopy if performed.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Accurate and timely interpretation of a kidney biopsy requires integration of light microscopic, immunofluorescent histology, and electron microscopic findings with clinical and laboratory data.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
An interpretive report will be provided.
Clinical References Provides recommendations for further in-depth reading of a clinical nature
1. Tisher CC: Clinical indication for kidney biopsy. In Renal Pathology: with Clinical and Functional Correlations. Vol. II. 2nd edition. Edited by CC Tisher, BM Brenner. Philadelphia, JB Lippincott Company, 1993, pp 75-84
2. Pirani CL: Evaluation of kidney biopsy specimens. In Renal Pathology: with Clinical and Functional Correlations. Vol. II. 2nd edition. Edited by CC Tisher, BM Brenner. Philadelphia, JB Lippincott Company, 1993, pp 85-115
3. Pirani CL, Croker BP: Handling and processing of renal biopsy and nephrectomy specimens. In Renal Pathology: with Clinical and Functional Correlations. Vol. II. 2nd edition. Edited by CC Tisher, BM Brenner. Philadelphia, JB Lippincott Company, 1993, pp 1683-1694