Felis ISSN 2398-2950

Biopsy: kidney

Contributor(s): Laura Owen, Rosa Ragni

Introduction

  • Sampling the kidney parenchyma.

Uses

  • To determine the pathology causing kidney dysfunction (eg in acute renal failure Kidney: acute renal failure, renal infiltrative disease including neoplasia, less commonly hematuria Hematuria and proteinuria Proteinuria).
  • If treatment will be altered by the results (eg in patients with glomerular disease or acute renal failure).
  • If prognosis is altered by the results (eg differentiating reversible from irreversible tubular necrosis).
  • To establish patient response to treatment or progression of renal disease.

Advantages

  • Allows accurate diagnosis, prognosis and clinical decisions.

Disadvantages

  • Not useful in cases of chronic renal failure Kidney: chronic kidney disease/end-stage renal disease.
  • Relatively high complication rate.
  • Contraindicated in patients with coagulopathies, hypertension, hydronephrosis, large or multiple renal cysts Kidney: perinephric/perirenal pseudocysts, perirenal abscess, extensive pyelonephritis Pyelonephritis, and masses or adhesions interfering with the proposed biopsy site.
    Thorough clinical evaluation of the patient is required before the procedure.Do NOT perform if unlikely to change treatment or prognosis.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Depending on underlying pathology.
  • Development of severe complications increases for patient of age greater than 4 years, body weight less than 5 kg, and presence of severe azotemia Azotemia, thrombocytopenia Thrombocytopenia or coagulopathy.
  • Obstructive renal failure may occur for biopsy of the single functioning kidney.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Lansdowne J L, Mehler S J, Bour√© L P (2012) Minimally Invasive Abdominal and Thoracic Surgery: techniques. Compend Contin Educ Pract Vet 34 (5), E2 PubMed.
  • Mayhew P (2009) Surgical Views - techniques for Laparoscopic and Laparoscopic-Assisted Biopsy of Abdominal Organs. Compend Contin Educ Pract Vet 31 (4), 170-6 PubMed.
  • Vaden S L (2005) Renal Biopsy of Dogs and Cats. Clin Tech Small Anim Pract 20 (1), 11-22 PubMed.
  • Vaden S L, Levine J F, Lees G E et al (2005) Renal Biopsy: A Retrospective Study of Methods and Complications in 283 Dogs and 65 Cats. JVIM 19 (6), 794-801 PubMed.
  • Groman R P, Bahr A, Berridge B R et al (2004) Effect of serial ultrasound guided renal biopsy on kidneys of healthy adolescent dogs. Vet Radiol Ultrasound 45 (1), 62-69 PubMed.
  • Rawlings C A, Howerth E W (2004) Obtaining quality biopsies of the liver and kidney. JAAHA 40 (5), 352-358 PubMed.
  • Vaden S L (2004) Renal biopsy: methods and interpretation. Vet Clin North Am Small Anim Pract 34 (4), 887-908 PubMed.

Other sources of information

  • Hotston Moore A,  Ragni R A (2012) Diagnostic Laparoscopy. In: Clinical Manual of Small Animal Endosurgery. Hotston Moore A, Ragni R A (eds), Wiley-Blackwell, Oxford.
  • Tillson D M, Tobias K M (2012) Kidneys. In: Veterinary Surgery Small Animal. Tobias K M (ed), Saunders, Philadelphia, pp 1944-1961.
  • Chew D J, DiBartola S P, Schenck P A (2011) Canine and Feline Nephrology and Urology.Elsevier Saunders, Philadelphia.
  • Lees G E, Bahr A, Sanders M H (2010) Performing Renal Biopsy. Clinician's Brief April 14.
  • Holt P E (2008) Urological disorders of the dog and cat. Manson Publishing, London.
  • Fossum T W (2007) Surgery of the Kidney and Ureter. In: Small Animal Surgery. 3rd Edition, Fossum T W (Ed), Mosby, S. Louis, pp 635-662.
  • Rawlings C A, Bjorling D E, Christie B A (2003) Kidneys. In: Textbook of Small Animal Surgery. Slatter D E (ed), 3rd edition, Saunders, Philadelphia, pp 1606-1619.


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