Kidney biopsy

A kidney biopsy is a medical procedure in which a small sample of kidney tissue is extracted and examined under a microscope. This procedure aids in diagnosing and determining the severity of various kidney disorders.

Introduction

A microscopic view of a kidney biopsy sample

Morbus Fabry kidney biopsy

The kidney biopsy has become an essential tool in nephrology, helping doctors diagnose unexplained proteinuria, hematuria, and renal failure. The procedure provides a direct insight into the kidney's structure and aids in the identification of inflammatory, scarring, and neoplastic processes.

Indications

A kidney biopsy might be prescribed for several reasons:

• Unexplained acute kidney injury or chronic kidney disease
• Nephrotic syndrome
• Persistent abnormal urine findings, like proteinuria or hematuria
• Monitoring of the kidney after transplantation

Procedure

The procedure can be categorized based on the approach:

• Percutaneous biopsy: This is the most common approach. Under imaging guidance, usually ultrasound, a needle is inserted through the skin to retrieve the kidney tissue.
• Transjugular biopsy: Used for patients who have contraindications for a percutaneous biopsy. It involves accessing the kidney via the jugular vein.
• Open biopsy: A surgical procedure where a small incision is made to access the kidney directly. This is less commonly done nowadays.

Complications

While kidney biopsies are generally safe, complications can arise:

• Bleeding or hematuria
• Pain at the biopsy site
• Hematoma formation
• Infection
• Injury to surrounding organs

Interpretation

The tissue obtained is typically examined under various types of microscopes, such as light, immunofluorescence, and electron microscopes, to determine the diagnosis. Findings can reveal conditions like:

• Glomerulonephritis
• Polycystic kidney disease
• Acute tubular injury
• Kidney cancer
• Interstitial nephritis
• Amyloidosis

The biopsy result will guide the clinician in determining the most suitable treatment regimen and predicting the disease's course.

Conclusion

The kidney biopsy is an indispensable tool in nephrology, helping in the definitive diagnosis and management of various kidney diseases. As with any invasive procedure, the benefits must always be weighed against potential risks.

References

Kidney biopsy Resources
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