|Values are valid only on day of printing.|
The evaluation and management of patients with kidney disease
Following the progression of known renal disease and/or response to therapy
Determining the cause of dysfunction in the transplanted kidney (allograft)
|Test ID||Reporting Name||Available Separately||Always Performed|
|4986||Renal Bx, Electron Microscopy||No||No|
|20500||RenalPath, Level IV, Wet Ts||No||No|
|9840||Periodic Acid-Schiff (PAS) ST||No||No|
|9828||Masson's Trichrome ST for Conn Ts||No||No|
|9889||Jones' Methenamine Silver ST||No||No|
|84226||Immunofluorescent C4d Stain||No||No|
|60301||IgA IF, Renal||No||No|
|60302||IgG IF, Renal||No||No|
|60304||Lambda IF, Renal||No||No|
|60305||Kappa IF, Renal||No||No|
|60306||C1q IF, Renal||No||No|
|60307||C3 IF, Renal||No||No|
|60308||Albumin IF, Renal||No||No|
|60309||Fibrinogen IF, Renal||No||No|
|60328||IgG1 IF, Renal||No||No|
|60329||IgG2 IF, Renal||No||No|
|60330||IgG3 IF, Renal||No||No|
|60331||IgG4 IF, Renal||No||No|
|60285||C1q Paraffin IF, Renal||No||No|
|60287||IgA Paraffin IF, Renal||No||No|
|60288||IgG Paraffin IF, Renal||No||No|
|60289||IgM Paraffin IF, Renal||No||No|
|60290||Kappa Paraffin IF, Renal||No||No|
|60291||Lambda Paraffin IF, Renal||No||No|
|60303||IgM IF, Renal||No||No|
|62196||RenalPath Consult, Outside Slide||No, (Bill Only)||No|
|62197||RenalPath Consult, w/Slide Prep||No, (Bill Only)||No|
|62198||RenalPath Consult, w/Comp Rvw of His||No, (Bill Only)||No|
The Renal Pathology Consultation is performed by a Mayo Clinic renal pathologist and entails the performance of appropriate procedures and stains based on the material received, patient information and specific findings on the case in order to determine a diagnosis. Optimal/standard diagnostic interpretation of a medical kidney biopsy requires integration of the light microscopy, immunofluorescence, and electron microscopy findings together with the clinical and laboratory data for the patient. We follow published standards by the Renal Pathology Society for the diagnostic evaluation and reporting of non-neoplastic renal disease.(1)
Wet/unprocessed tissue submitted for light microscopy routinely includes the preparation of stains, which include hematoxylin and eosin (H and E), periodic acid Schiff (PAS), Masson trichrome, and Jones methenamine silver stains.
Wet/unprocessed tissue submitted for immunofluorescence may include the following stains in order to render an accurate diagnosis. These stains include: IgA, IgG, IgM, C1q, C3, albumin, fibrinogen, kappa light chain, and lambda light chain stains with C4d added if the biopsy is an allograft.
The IgG subtypes (IgG1, IgG2, IgG3, IgG4) are typically only utilized if the biopsy shows features suspicious for a monoclonal/monotypic deposition process involving IgG.
Alport (collagen IV, alpha 2 and alpha 5) staining is performed in the setting of biopsy findings that are consistent with hereditary nephritis/Alport syndrome.
Paraffin-Based Immunofluorescence Stains:
The paraffin-based immunofluorescence stains listed above would only be utilized in the special circumstance when there is no tissue or inadequate tissue available for standard immunofluorescence or if there are findings that raise concern for so-called “masked” deposits.
Phospholipase A2 Receptor (PLA2R) staining is performed in the setting of membranous nephropathy/glomerulonephritis to aid in determining whether it is most likely primary/idiopathic or secondary.
Wet/unprocessed tissue submitted for electron microscopy will be processed for transmission electron microscopy. A formal interpretive report is issued, incorporating the findings from all tests performed for diagnostic purposes.
See Pathology Consultation Ordering Algorithm in Special Instructions.