Clinicopathological evaluatıon of our renal biopsies in the last five years

Abstract

Renal biopsy is the gold standard diagnostic choice for renal diseases. It is used for determining the prognosis, and choosing the right treatment modality for renal diseases. The purpose of this study was the clinicopathological evaluation of our renal biopsies in the last 5 years. Material and Method: In our study, we evaluated 140 native percutaneus renal biopsies retrospectively, that were taken in the years 2004 – 2009,from patients interned in the 5th and 2nd Internal Medicine Clinics of our hospital. The biopsies were performed with full-automatic biopsy needles under ultrasonographic guidance. Hematoxylin- Eosin (HE), Periodic Acid-Schiff(PAS), Periodic Acid-Schiff Metanamine (PAS-M), Masson Trichrome, Crystal Violet and Kongo Red were applied for light microscopy; and IgG, IgM, IgA, C3, and Fibrinogen antibodies were applied with the direct immunfluorescent method for Immunfluorescent study. Findings: The mean age was 43.2±17.1. 81 of 140 patients were male(58.7%), whereas 57 patients were female(41.3%). There were a minimum of 2 and maximum 37 glomerules (Mean glomerule Count: 15.3±7.5) in the biopsy samples. Sufficent glomerule number was met in 70% cases (98/140). Most common endication for biopsy was nephrotic syndrome in 85 of 140 (60.7%) patients; whereas most common diagnosis was Focal Segmental Glomerulosclerosis (FSGS) (N=29, 21%). Conclusion: In our study most common diagnosis was FSGS; and second most common was amiloidosis. Even though in many studies the most frequent renal-biopsy diagnosis is Berger’s nephropathy; in our study it was as low as 5.8%. Furthermore; upon futher examination of the biopsies diagnoased as FSGS; we have come to the conclusion that a considerable portion of them might in fact be benign nephrosclerosis, and when diagnosing biopsy samples as FSGS, considering secondary FSGS with a thorough clinicopathological evaluation would be beneficial for both treatment and prognosis.