RENAL BIOPSY AND POST BIOPSY COMPLICATIONS-A CASE SERIES AT MULTICENTRES

Abstract

Percutaneous renal biopsy (PRB) is still considered an irreplaceable tool for diagnosis, prognosis and choice of treatment of several primary or secondary kidney diseases. The indications uniformly recognized by most nephrologists are represented by nephritic and/or nephrotic syndrome and unexplained acute or rapidly progressive renal failure[1].Primary glomerulonephritis are the more common renal disease in renal biopsy registries.Among them IgA nephropathy (IgAN) is the most frequent renal diagnosis. Regarding systemic diseases,SLE is the most frequent indication for PRB, because this last determines the level of activity and/or chronicity of the lesions and the reversibility of renal lesion as a result of therapy. PRB can also be helpful in vasculitis to assess the severity of the damage and the potential reversibility after therapy. In diabetes the use of PRB is motivated by a relatively recent or very late appearance of proteinuria > 1 g and/or a rapid decline in GFR and/or active urinary sediment, in the absence of other signs of microangiopathy (retinopathy and neuropathy).In advanced chronic renal failure, PRB is useful to assess a rescue therapy or to know the causal nephropathy in view of renal transplantation[2].PRB is also an informative procedure in renal transplantation, both in the postoperative, for the differential diagnosis of acute rejection vs other diseases, and in follow­up of organ transplantation for differential diagnosis between recurrence of primary renal disease, development of glomerulonephritis ex novo, and acute or chronic rejection.