Large Renal Corpuscle: Clinical Significance of Evaluation of the Largest Renal Corpuscle in Kidney Biopsy Specimens

2018 ◽  
pp. 20-30 ◽  
Author(s):  
Hiroshi Kataoka ◽  
Toshio Mochizuki ◽  
Kosaku Nitta
Keyword(s):  
Clinical Significance ◽  
Kidney Biopsy ◽  
Renal Corpuscle ◽  
Biopsy Specimens

scholarly journals In Patients with Membranous Lupus Nephritis, Exostosin-Positivity and Exostosin-Negativity Represent Two Different Phenotypes

2021 ◽  
pp. ASN.2020081181 ◽  
Author(s):  
Aishwarya Ravindran ◽  
Marta Casal Moura ◽  
Fernando C. Fervenza ◽  
Samih H. Nasr ◽  
Mariam P. Alexander ◽  
...  
Keyword(s):  
Lupus Nephritis ◽  
Kidney Biopsy ◽  
Interstitial Fibrosis ◽  
Study Cohort ◽  
Lower Serum ◽  
Tubular Atrophy ◽  
Novel Proteins ◽  
Biopsy Specimens ◽  
Membranous Lupus Nephritis

BackgroundIn patients with secondary (autoimmune) membranous nephropathy, two novel proteins, Exostosin 1 and Exostosin 2 (EXT1/EXT2), are potential disease antigens, biomarkers, or both. In this study, we validate the EXT1/EXT2 findings in a large cohort of membranous lupus nephritis.MethodsWe conducted a retrospective cohort study of patients with membranous lupus nephritis, and performed immunohistochemistry studies on the kidney biopsy specimens against EXT1 and EXT2. Clinicopathologic features and outcomes of EXT1/EXT2-positive versus EXT1/EXT2-negative patients were compared.ResultsOur study cohort included 374 biopsy-proven membranous lupus nephritis cases, of which 122 (32.6%) were EXT1/EXT2-positive and 252 (67.4%) were EXT1/EXT2-negative. EXT1/EXT2-positive patients were significantly younger (P=0.01), had significantly lower serum creatinine levels (P=0.02), were significantly more likely to present with proteinuria ≥3.5 g/24 h (P=0.009), and had significantly less chronicity features (glomerulosclerosis, P=0.001 or interstitial fibrosis and tubular atrophy, P<0.001) on kidney biopsy. Clinical follow-up data were available for 160 patients, of which 64 (40%) biopsy results were EXT1/EXT2-positive and 96 (60%) were EXT1/EXT2-negative. The proportion of patients with class 3/4 lupus nephritis coexisting with membranous lupus nephritis was not different between the EXT1/EXT2-positive and EXT1/EXT2-negative groups (25.0% versus 32.3%; P=0.32). The patients who were EXT1/EXT2-negative evolved to ESKD faster and more frequently compared with EXT1/EXT2-positive patients (18.8% versus 3.1%; P=0.003).ConclusionsThe prevalence of EXT1/EXT2 positivity was 32.6% in our cohort of membranous lupus nephritis. Compared with EXT1/EXT2-negative membranous lupus nephritis, EXT1/EXT2-positive disease appears to represent a subgroup with favorable kidney biopsy findings with respect to chronicity indices. Cases of membranous lupus nephritis that are EXT1/EXT2-negative are more likely to progress to ESKD compared with those that are EXT1/EXT2-positive.

Evaluation of Frozen and Paraffin Sections Using the Maryland Aggregate Pathology Index Score in Donor Kidney Biopsy Specimens of a Brazilian Cohort

2017 ◽  
Vol 49 (10) ◽  
pp. 2247-2250
Author(s):  
A.C. Teixeira ◽  
C.C. Freire de Carvalho ◽  
G.P. Mororó ◽  
L.D.M. Pereira ◽  
V.S. Lacerda ◽  
...  
Keyword(s):  
Kidney Biopsy ◽  
Index Score ◽  
Paraffin Sections ◽  
Donor Kidney ◽  
Biopsy Specimens ◽  
Brazilian Cohort

Cellular and molecular interrogation of kidney biopsy specimens

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Michael T. Eadon ◽  
Pierre C. Dagher ◽  
Tarek M. El-Achkar
Keyword(s):  
Kidney Biopsy ◽  
Biopsy Specimens

scholarly journals Glomerular Immunodeposits of Patients with IgA Nephropathy Are Enriched for IgG Autoantibodies Specific for Galactose-Deficient IgA1

2019 ◽  
Vol 30 (10) ◽  
pp. 2017-2026 ◽  
Author(s):  
Dana V. Rizk ◽  
Manish K. Saha ◽  
Stacy Hall ◽  
Lea Novak ◽  
Rhubell Brown ◽  
...  
Keyword(s):  
Confocal Microscopy ◽  
Iga Nephropathy ◽  
Kidney Biopsy ◽  
Immunofluorescence Microscopy ◽  
Kidney Tissue ◽  
Antigenic Specificity ◽  
Biopsy Specimens ◽  
Phospholipase A2 Receptor ◽  
Sds Page ◽  
Specific Igg

BackgroundIgA nephropathy (IgAN) is the leading primary GN worldwide. The disease is thought to result from glomerular deposition of circulating immune complexes of IgG bound to galactose-deficient IgA1 (Gd-IgA1). However, routine immunofluorescence microscopy fails to detect IgG in many kidney biopsies from patients with IgAN and the specificity of IgG in immunodeposits has not been tested.MethodsWe used remnant frozen kidney-biopsy specimens from 34 patients with IgAN; 14 were IgG-positive and 20 were IgG-negative by routine immunofluorescence microscopy. Six patients with primary membranous nephropathy (MN) and eight with lupus nephritis (LN) served as controls. IgG in the kidney tissue was extracted and its amount determined by ELISA. IgG molecular integrity was assessed by SDS-PAGE immunoblotting. Antigenic specificity of extracted IgG was determined by ELISA using phospholipase A2 receptor (PLA2R) or Gd-IgA1 as antigen. In addition, ten other IgAN cases, six IgG-positive and four IgG-negative by routine immunofluorescence, were used for colocalization studies by confocal microscopy.ResultsIgG extracted from MN but not IgAN immunodeposits reacted with PLA2R. Conversely, IgG extracted from IgAN but not MN or LN immunodeposits reacted with Gd-IgA1. Even IgAN kidney-biopsy specimens without IgG by routine immunofluorescence microscopy had IgG specific for Gd-IgA1. Confocal microscopy confirmed the presence of IgG in the IgAN biopsies with colocalization of glomerular IgA and IgG.ConclusionsThese results reveal for the first time that IgAN kidney biopsies, with or without IgG by routine immunofluorescence, contain Gd-IgA1–specific IgG autoantibodies. These findings support the importance of these autoantibodies in the pathogenesis of IgAN.

P0132DIAGNOSIS OF HYPEROXALURIA FROM RENAL BIOPSY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marwa Omrane ◽  
Raja Aoudia ◽  
Mondher Ounissi ◽  
Nada Sellami ◽  
Mouna Jerbi ◽  
...  
Keyword(s):  
Renal Failure ◽  
Kidney Disease ◽  
Renal Biopsy ◽  
Kidney Biopsy ◽  
Interstitial Fibrosis ◽  
Renal Pathology ◽  
Crystal Deposition ◽  
Biopsy Specimens ◽  
Initial Symptoms ◽  
History Of

Abstract Background and Aims Crystal-induced kidney disease refers to kidney injury caused by intratubular crystal deposition. The most common forms of crystalline nephropathy encountered in renal pathology are nephrocalcinosis and oxalate nephropathy. The purpose of our study is to determine the epidemiological and clinical characteristics of hyperoxaluria diagnosed from renal biopsy. Method We retrospectively reviewed all kidney biopsy specimens evaluated at renal pathology laboratory, from 1976 to 2019. The biopsy specimens were received from multiple medical department and medical centers. We studied 8900 biopsy specimens and we were focused on patients whose diagnosis of hyperoxaluria was made from renal biopsy Results We identified 25 cases (15 children and 10 adults) with a sex ratio H / F of 0.9. Mean age at diagnosis was 17.2 years old [4 months-73 years old]. Most patients were offspring of consanguineous mating (14 of 25) with intermarriage of first-degree cousins being the most common pattern. A family history of chronic kidney disease was found in 13 patients: indeterminated nephropathy (n = 6) and renal stone (n = 5) and primary hyperoxaluria (n=2). Among our patients, five had a history of urolithiasis. One patient had a history of chronic diarrhea related to Crohn's disease and one patient had a history of cephalic pancreatectomy and ileal resection. Initial symptoms and signs were dominated by renal failure (n = 25) with mean creatinine of 789.5 μmol / l [306-1832μmol / l], associated with proteinuria in 10 patients and hematuria in 11 patients. Arterial hypertension was present in 4 patients. Oligo anuria was reported in 4 patients without dilation of the urinary excretory pathways. In our patients, the diagnosis of crystalin nephropathy was revealed by renal biopsy. In one case, the diagnosis was made after renal transplant. In 4 cases the diagnosis was made by postmortem kidney biopsy. In all cases, the kidney biopsy specimen showed extensive intratubular crystal deposition and tubulointerstitial mononuclear cell infiltration with features of tubular injury and interstitial fibrosis. Examination of histologic slides showed colorless refractile crystals of polygonal appearance. Multicolored birefringence under polarized light identified these crystals as calcium oxalate. After different investigations (genetic and biological analysis), the diagnosis of hyperoxaluria was confirmed. Hyperoxaluria was primary in 23 patients and secondary in 2 patients. Conclusion Hyperoxaluria is a rare condition, often serious, involving renal prognosis and sometimes life-threatening, especially in early-onset forms. Early diagnosis and treatment should be done as soon as possible to slow the progression to end-stage renal failure. In patients with renal insufficiency, the diagnosis of hyperoxaluria is difficult. Renal biopsy can help when clinical and radiological data are not sufficient.

scholarly journals The Prognostic Value of Histopathologic Lesions in Native Kidney Biopsy Specimens: Results from the Boston Kidney Biopsy Cohort Study

2018 ◽  
Vol 29 (8) ◽  
pp. 2213-2224 ◽  
Author(s):  
Anand Srivastava ◽  
Ragnar Palsson ◽  
Arnaud D. Kaze ◽  
Margaret E. Chen ◽  
Polly Palacios ◽  
...  
Keyword(s):  
Cohort Study ◽  
Kidney Disease ◽  
Confidence Interval ◽  
Disease Progression ◽  
Kidney Biopsy ◽  
Hazard Ratio ◽  
Prognostic Information ◽  
Biopsy Specimens ◽  
Native Kidney ◽  
Kidney Disease Progression

Background Few studies have evaluated whether histopathologic lesions on kidney biopsy provide prognostic information beyond clinical and laboratory data.Methods We enrolled 676 individuals undergoing native kidney biopsy at three tertiary care hospitals into a prospective, observational cohort study. Biopsy specimens were adjudicated for semiquantitative scores in 13 categories of histopathology by two experienced renal pathologists. Proportional hazards models tested the association between histopathologic lesions and risk of kidney disease progression (≥40% eGFR decline or RRT).Results Mean baseline eGFR was 57.5±36.0 ml/min per 1.73 m2. During follow-up (median, 34.3 months), 199 individuals suffered kidney disease progression. After adjustment for demographics, clinicopathologic diagnosis, and laboratory values, the following lesions (hazard ratio; 95% confidence interval) were independently associated with progression: inflammation in nonfibrosed interstitium (0.52; 0.32 to 0.83), moderate and severe versus minimal interstitial fibrosis/tubular atrophy (2.14; 1.24 to 3.69 and 3.42; 1.99 to 5.87, respectively), moderate and severe versus minimal global glomerulosclerosis (2.17; 1.36 to 3.45 and 3.31; 2.04 to 5.38, respectively), moderate and severe versus minimal arterial sclerosis (1.78; 1.15 to 2.74 and 1.64; 1.04 to 2.60, respectively), and moderate and severe versus minimal arteriolar sclerosis (1.63; 1.08 to 2.46 and 2.33; 1.42 to 3.83, respectively). An 11-point chronicity score derived from semiquantitative assessments of chronic lesions independently associated with higher risk of kidney disease progression (hazard ratio per one-point increase, 1.19; 95% confidence interval, 1.12 to 1.27).Conclusions Across a diverse group of kidney diseases, histopathologic lesions on kidney biopsy provide prognostic information, even after adjustment for proteinuria and eGFR.

Clinical Significance of Telomerase Activity in Biopsy Specimens of Gastric Cancer

2000 ◽  
Vol 30 (1) ◽  
pp. 61-63 ◽  
Author(s):  
Yasushi Okusa ◽  
Takashi Ichikura ◽  
Hidetaka Mochizuki ◽  
Nariyoshi Shinomiya
Keyword(s):  
Gastric Cancer ◽  
Clinical Significance ◽  
Telomerase Activity ◽  
Biopsy Specimens

scholarly journals Investigation of the Clinical Significance and Pathological Features of Lanthanum Deposition in the Gastric Mucosa

2020 ◽  
Author(s):  
Shinya Nishida ◽  
Kazuhiro Ota ◽  
Kimiaki Hattori ◽  
Taro Iwatsubo ◽  
Yuichi Kojima ◽  
...  
Keyword(s):  
Gastric Mucosa ◽  
Total Dose ◽  
Clinical Significance ◽  
Medical Information ◽  
University Hospital ◽  
Clinical Trial Registry ◽  
Background Factors ◽  
Biopsy Specimens ◽  
Significant Difference ◽  
Histiocytic Infiltration

Abstract Background: There are often specific endoscopic findings caused by deposition of lanthanum (La) in the gastric mucosa of patients taking lanthanum carbonate (LaC), a novel phosphate binder for patients on hemodialysis. We conducted a retrospective study to investigate the clinical significance of Ladeposition in the gastric mucosa, and the association between endoscopic features and histologic findings in the same population.Methods:We compared background factors in patients taking LaC with and without Ladeposition in their gastroscopic biopsy specimen. We also investigated the relationship between gastric endoscopic biopsy specimens with Ladeposition and the concurrent endoscopic images.Results:There was a significant difference in the total dose of LaC between the La-positive and La-negative groups(990 g [180–3150 g] vs. 480 g [225–1328 g]; p=0.013). In 27 biopsy specimens with specific whitish mucosa, 10 showed mild histiocytic infiltration and 17 showed strong infiltration. In contrast, among 24 specimens with non-whitishmucosa, five showed no histiocytic infiltration, 10 showed mild infiltration, and nine showed strong infiltration. There was a significant relationship between endoscopic features and the degree of histiocytic infiltration (p=0.026).Conclusions: We demonstrated that Ladeposition in the gastric mucosa depended on the total dose of LaC and was not affected by background factors. The specific endoscopic features of Ladeposition are associated with the infiltration of histiocytes, which represents the body’s normal response to foreign bodies.The protocol was registered in the University Hospital Medical Information Network Clinical Trial Registry (UMIN000038929).

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