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Concept
Renal biopsy
Summary
Renal biopsy (also kidney biopsy) is a medical procedure in which a small piece of kidney is removed from the body for examination, usually under a microscope. Microscopic examination of the tissue can provide information needed to diagnose, monitor or treat problems of the kidney.
A renal biopsy can be targeted to a particular lesion, for example a tumour arising from the kidney (targeted renal biopsy). More commonly, however, the biopsy is non-targeted as medical conditions affecting the kidney typically involve all kidney tissue indiscriminately. In the latter situation, any sufficiently sized piece of kidney tissue can be used.
A native renal biopsy is one in which the patient's own kidneys are biopsied. In a transplant renal biopsy, the kidney of another person that has been transplanted into the patient is biopsied. Transplant kidney biopsy can be performed when nothing is apparently wrong with the transplant kidney for the purposes of surveillance for hidden disease (protocol transplant biopsy). This is typically done at 0, 3 and 12 months post-transplant according to a transplant unit protocol. Biopsy of the transplanted kidney taken during the transplant operation is termed implantation transplant biopsy or post-perfusion transplant biopsy depending on the timing of the biopsy with respect to key stages of the operation. When the transplanted kidney is not working properly, biopsy may be undertaken to identify the cause of dysfunction. This is referred to as an indication transplant biopsy, because something has prompted the performance of the biopsy.
Renal biopsy may be performed with the aid of "real-time" medical imaging to guide the positioning of biopsy equipment (imaging-guided renal biopsy). Alternatively, a biopsy may be performed without imaging-guidance using indirect assessments of position such as "needle-swing" to confirm appropriate placement of biopsy equipment (blind renal biopsy).
Before 1951, the only way of obtaining kidney tissue from a live person was through an open operation.
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Related courses (1)
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Nephritic syndrome is a syndrome comprising signs of nephritis, which is kidney disease involving inflammation. It often occurs in the glomerulus, where it is called glomerulonephritis. Glomerulonephritis is characterized by inflammation and thinning of the glomerular basement membrane and the occurrence of small pores in the podocytes of the glomerulus. These pores become large enough to permit both proteins and red blood cells to pass into the urine (yielding proteinuria and hematuria, respectively).
Membranoproliferative glomerulonephritis
Membranoproliferative glomerulonephritis (MPGN) is a type of glomerulonephritis caused by deposits in the kidney glomerular mesangium and basement membrane (GBM) thickening, activating complement and damaging the glomeruli. MPGN accounts for approximately 4% of primary renal causes of nephrotic syndrome in children and 7% in adults. It should not be confused with membranous glomerulonephritis, a condition in which the basement membrane is thickened, but the mesangium is not.
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Azotemia (azot, "nitrogen" + -emia, "blood condition") is a medical condition characterized by abnormally high levels of nitrogen-containing compounds (such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds) in the blood. It is largely related to insufficient or dysfunctional filtering of blood by the kidneys. It can lead to uremia and acute kidney injury (kidney failure) if not controlled. Azotemia has three classifications, depending on its causative origin: prerenal azotemia, renal azotemia, and postrenal azotemia.