Importance of Renal Biopsy in Contemporary Nephrology

Overview

Technique of the procedure and morphological examination of a renal biopsy specimen has beenthoroughly elaborated. Its diagnostic value and the asset for guiding treatment outweighs theperformance associated risks. Evaluation of the specimen by an experienced nephropathologistis very important. When assessing a renal biopsy it is necessary to focus not only the glomerularbut also tubular, intersticial and vascular changes. Indications for renal biopsy are continuouslyprecised and gradually their frequency declines. Kidney biopsy is needed in case of suspectedrapidly progressive glomerulonephritis, in prolonged acute renal failure of uncertain cause, inchronic glomerulonephritis unresponsive to steroids prior to commencing cytotoxic treatmentand in cases we can not diagnose on the basis of clinical analysis. Diagnosis of a non-immunedisease will spare the patient from the risks of immunosuppressive treatment. Estimation ofthe destroyed renal parenchyma in the biopsy enables appropriate timing of the therapy whichcan slow the progression of chronic renal failure. Biopsy of the transplanted kidney is irrepla-ceable in the differential diagnosis of rejection nephropathy and the choice of its treatment.New methods of biopsy specimen processing will, no doubt, provide further diagnostic findings.However, light microscopy, immunoflurescence and electron microscopy represent currentlysufficient clinical tools.

Key words:
nephrology - renal biopsy - diagnostic value - description of the sample.