'Was my kidneybiopsy worth it?'-A qualitative phenomenological study of patient experiences and perceived barriers to kidneybiopsy. Kidneybiopsy is an important investigation in nephrology and facilitates the diagnosis of many conditions. It is an invasive procedure with the risk of significant complications, which limits its usage. There is minimal literature on how patients experience a kidneybiopsy. Identifying and addressing barriers to access may expand opportunities for diagnosis and treatment. We hypothesise that patients experience kidneybiopsy differently, depending on each individual's circumstances. Ten participants, who had undergone a total of twenty-three kidneybiopsies were recruited through purposive sampling. They were interviewed about how they experienced
Implementation and first report of the Brazilian KidneyBiopsy Registry. Kidneybiopsy registries are valuable tools for guiding clinical practice and developing health policies. In 2021, the Brazilian Society of Nephrology (SBN) created the Brazilian KidneyBiopsy Registry (BKBR). This is the first BKBR report, presenting patient data from 2021. BKBR is a web-based platform hosted on the BSN website, which contains patient demographics, clinical data, frequency, and distribution of histologic diagnosis of Brazilian adult native kidneybiopsies. Of the 1012 cases registered in 2021, 954 cases were evaluated after excluding pediatric and kidney transplant cases. Twenty-one centers enrolled patients, with representation from all Brazilian regions. There was a slight predominance of females
Puncture approaches for ultrasound-guided kidneybiopsy specimens: a pediatric model study using piglet kidneys. The optimal puncture approach for real-time ultrasound-guided native kidney needle biopsy in children remains undetermined due to insufficient evidence. This study evaluated various puncture approaches for glomeruli count and arterial injury in the small kidneys of piglets. A total and Vertical approaches are advantageous for selective glomerular sampling without increasing the arterial injury risk. Although further research on smaller kidneys is necessary, these findings offer valuable guidance for biopsy approaches to small kidneys, particularly in pediatric patients. Kidneybiopsy is essential for establishing diagnosis and determining treatment strategies; however
Challenges in standardizing preimplantation kidneybiopsy assessments and the potential of AI-Driven solutions. This review explores the variability in preimplantation kidneybiopsy processing methods, emphasizing their impact on histological interpretation and allocation decisions driven by biopsy findings. With the increasing use of artificial intelligence (AI) in digital pathology of preimplantation kidneybiopsy assessments. However, their clinical application remains limited due to a lack of proven associations with posttransplant outcomes and insufficient evaluation of predictive performance metrics. Future research should prioritize longitudinal studies using large-scale datasets, rigorous validation, and comprehensive assessments of predictive performance for both short- and long-term
Norwegian kidneybiopsy biobank (NorKiBB): organization, baseline characteristics, and generalizability of a low-cost national biobank. Biobanks that hold blood, urine and kidney tissue are key for translational nephrology research but are few and have limited availability. We describe the organization, baseline characteristics, and generalizability of a low-cost national biobank. Eight Norwegian hospitals participated in this multi-center, prospective cohort study and biobank initiative. Patients referred for routine clinical native kidneybiopsies were eligible for inclusion, starting September 2020. Extensive information on medical history and risk factors were collected into an encrypted on-line database by the treating nephrologist. A comprehensive standardized panel of blood
A Randomized Controlled Trial of Video-Assisted Electronic Consent Versus Standard Consent for Percutaneous KidneyBiopsy. Informed consent is crucial in healthcare, as it respects and honors patient autonomy. However, the process of consenting a patient to a procedure or intervention is often unstandardized, leading to gaps in comprehension, which in turn affects decision-making. This study aimed to assess the patient-reported benefits of video-assisted electronic consent (eConsent) compared with the usual consent practices for percutaneous kidneybiopsies (PKB). In this single-center, open-label, randomized controlled trial, consecutive patients undergoing PKB between July 2021 and January 2024 were randomized (1:1) to either video-assisted eConsent (intervention) or usual practice
Plasma Proteins associated with Chronic Histopathologic Lesions on KidneyBiopsy. The severity of chronic histopathologic lesions on kidneybiopsy is independently associated with higher risk of progressive chronic kidney disease (CKD). Because kidneybiopsies are invasive, identification of blood markers that report on underlying kidney histopathology has the potential to enhance CKD care. We examined the association between 6592 plasma protein levels measured by aptamers and the severity of interstitial fibrosis and tubular atrophy (IFTA), glomerulosclerosis, arteriolar sclerosis, and arterial sclerosis among 434 participants of the Boston KidneyBiopsy Cohort. For proteins significantly associated with at least one histologic lesion, we assessed renal arteriovenous protein gradients among
IgA vasculitis nephritis: insights from kidneybiopsies. To present findings indicating the value of kidneybiopsy in assessing prognosis and guiding clinical approach to patients with IgA vasculitis nephritis (IgAVN), including a recent international study examining the value of the Oxford (MEST-C) classification. Historically, kidneybiopsies with IgAVN are scored using the International
Histopathological Features and Role of Allograft KidneyBiopsy Among Recipients With Prolonged Delayed Graft Function: A Review. Delayed graft function (DGF) is an early posttransplant complication predictive of adverse outcomes. This "acute kidney injury of transplantation" is often defined as allograft dysfunction requiring renal replacement within 7 d posttransplantation. DGF is an important area of study because it is emerging with efforts to expand the donor pool and address the supply-demand gap in kidney transplantation. DGF is often caused by severe kidney injury mechanisms because of multiple donors, recipients, and immunologic factors. The role of kidneybiopsy, particularly in prolonged DGF, is an ongoing area of research and inquiry for clinicians and researchers alike to better
Improving frozen section evaluation of procurement donor kidneybiopsies and reducing the discard rate: a promising role for artificial intelligence. There is a worldwide shortage of deceased-donor kidneys available for transplantation, with too many patients dying while on waiting lists for organs. Meanwhile, and particularly in the United States, many recovered kidneys are discarded, often
Urinary N-acetyl-D-glucosaminidase can predict bleeding after a percutaneous kidneybiopsy. A percutaneous kidneybiopsy (PKB) allows nephrologists to make informed decisions for treating various kidney diseases; however, the risk of bleeding complications should be considered, given the vascularity of the kidney. Many studies have reported risk factors for bleeding events after a PKB. However
Assessment of biological organ age using molecular pathology in pre-transplant kidneybiopsies. Organ shortage is a major challenge in kidney transplantation but the use of older donors, often with co-morbidities, is hampered by inconsistent outcomes. Methods of accurately stratifying marginal donor organs by clinical and histological assessment are lacking. To better understand organ variability
Application of spatial-omics to the classification of kidneybiopsy samples in transplantation. Improvement of long-term outcomes through targeted treatment is a primary concern in kidney transplant medicine. Currently, the validation of a rejection diagnosis and subsequent treatment depends on the histological assessment of allograft biopsy samples, according to the Banff classification system
Anti-slit diaphragm antibodies on kidneybiopsy identify pediatric patients with steroid-resistant nephrotic syndrome responsive to second-line immunosuppressants. Podocytopathies represent a group of glomerular disorders associated with minimal changes (MC) or focal segmental glomerulosclerosis (FSGS) lesion patterns at biopsy and heterogeneous responses to steroids. Anti-nephrin antibodies were previously found in such patients, suggesting an autoimmune form of podocytopathy. High resolution confocal microscopy on kidneybiopsies of a cohort of 128 pediatric patients revealed localization of IgG along the slit diaphragm in 30% of patients with MC and 25% of those with FSGS, but not in other lesion patterns. Anti-nephrin IgG ELISA assay in the serum and stimulated emission depletion microscopy
Cardiovascular autonomic neuropathy in chronic kidney disease: a study of kidneybiopsy cases. The interplay between cardiac and kidney functions is mediated by the autonomic nervous system. Cardiovascular autonomic neuropathy (CAN) is a well-documented dysfunction of this system, with heart rate variability (HRV) serving as the principal diagnostic tool. CAN is recognized as a prognostic marker for adverse kidney outcomes in diabetic kidney disease (DKD). However, the pathogenesis of CAN in patients with nondiabetic chronic kidney disease (CKD) remains underexplored. This study elucidated the prevalence of CAN and its clinicopathologic characteristics in patients with nondiabetic CKD. This cross-sectional analysis evaluated 165 nondiabetic CKD patients who underwent kidneybiopsy from 2020 to 2023
Saline versus balanced crystalloids for hydration post-kidneybiopsy. Isotonic fluids are becoming the standard for hydration and maintenance fluid therapy, but there is no consensus on the optional choice among the different types of isotonic solution. This study is a single-center, non-randomized controlled trial at Kobe University Hospital, Japan, between April 2021 and March 2023. The study included pediatric patients aged 1-19 years who underwent kidneybiopsies. From April 2021 to March 2022, 0.9% sodium chloride (saline) was administered, and from April 2022 to March 2023, balanced crystalloids were used. The primary outcome was the occurrence of hyponatremia (< 137 mEq/L) after a kidneybiopsy. Secondary outcomes included other electrolyte balances, blood gas parameters, creatinine
An International Study of Variation in Attitudes to KidneyBiopsy Practice. A kidneybiopsy is an essential investigation for diagnosis but is invasive and associated with complications. Delaying or missing the opportunity to diagnose kidney disease could result in adverse patient outcomes. This study aimed to examine attitudes to kidneybiopsy across the world. An online questionnaire , younger clinicians, frequent performers of kidneybiopsy, increased job seniority and larger institution size (P=0.05). Kidneybiopsy practice is varied internationally and is subject to human and systemic factors. Further research is required to understand the variances behind clinical decision making.
The diagnostic value of native kidneybiopsy in low grade, subnephrotic, and nephrotic range proteinuria: A retrospective cohort study. In nephrotic range proteinuria of adult-onset, kidneybiopsy is the diagnostic gold standard in determining the underlying cause of disease. However, in low grade or subnephrotic proteinuria the diagnostic value of kidneybiopsy as first-line diagnostics is less well established. We conducted a retrospective analysis of all native kidneybiopsies at our institution (n = 639) between 01/2012 and 05/2021 for comparison of histological diagnoses and clinical outcomes stratified by amount of proteinuria at the time of kidneybiopsy: A: <300mg/g creatinine (low grade), B: 300-3500mg/g creatinine (subnephrotic), C >3500mg/g creatinine (nephrotic). Nephrotic range
The evolution of performing a kidneybiopsy: a single center experience comparing native and transplant kidneybiopsies performed by interventional radiologists and nephrologists. Kidneybiopsy is the most vital tool guiding a nephrologist in diagnosis and treatment of kidney disease. Over the last few years, we have seen an increasing number of kidneybiopsies being performed by interventional radiologists. The goal of our study was to compare the adequacy and complication rates between kidneybiopsies performed by interventional radiology versus nephrology. METHODS : We performed a single center retrospective analysis of a total of all kidneybiopsies performed at our Institution between 2015 and 2021. All biopsies were performed using real-time ultrasound. Patients were monitored for four hours