Renal biopsy: methods and interpretation (original) (raw)
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Journal of Veterinary Internal Medicine, 2013
Background: Human renal biopsies are routinely evaluated with light microscopy (LM) using a panel of histologic stains, transmission electron microscopy (TEM), and immunofluorescence (IF) microscopy to obtain a diagnosis. In contrast, the pathologic evaluation of glomerular disease in veterinary medicine has relied mostly on LM and was of limited utility. To address this problem, recently established veterinary renal diagnostic centers have adopted methods used in human nephropathology for evaluation of renal biopsies. Three broad categories of disease, which have the greatest implications for clinical management of proteinuric dogs, have been established and include amyloidosis, immune complex-mediated glomerulonephritis (ICGN), and non-ICGN.
Pilot Evaluation of a Vacuum-Assisted Biopsy Instrument for Percutaneous Renal Biopsy in Dogs
Journal of The American Animal Hospital Association, 2011
Kidney biopsies in dogs are commonly obtained using automated spring-loaded biopsy instruments. Interpretation of biopsies from dogs with glomerular disease requires examination of at least 5-10 glomeruli, with at least two biopsies usually required for full evaluation. The purpose of this study was to compare quality and interpretability of renal biopsies obtained from healthy dogs with a large-gauge, vacuum-assisted biopsy instrument versus two biopsies obtained with a spring-loaded biopsy needle. Twenty dogs were randomized into two groups, and percutaneous, ultrasound-guided renal biopsies were evaluated using standard criteria. There were no significant differences in the number of biopsies that contained renal tissue, cortex, or medulla. Biopsies obtained with either instrument contained an adequate number of glomeruli and an equivalent number of arterioles and severity of tissue compression. Differences included easier penetration of the renal capsule and collection of sufficient tissue for interpretation with only one instrument pass when using the vacuum-assisted device (vs two passes required with the spring-loaded instrument). Before use in client-owned dogs, future studies should evaluate whether these differences are clinically relevant advantages in the diagnostic evaluation of dogs with kidney disease, and determine the prevalence and severity of complications when using this larger gauge device.
Veterinary Pathology, 2015
Evaluation of canine renal biopsy tissue has generally relied on light microscopic (LM) evaluation of hematoxylin and eosin-stained sections ranging in thickness from 3 to 5µm. Advanced modalities, such as transmission electron microscopy (TEM) and immunofluorescence (IF), have been used sporadically or retrospectively. Diagnostic algorithms of glomerular diseases have been extrapolated from the World Health Organization classification scheme for human glomerular disease. With the recent establishment of two veterinary nephropathology services, which evaluate 3 µm sections with a panel of histochemical stains and routinely perform TEM and IF, a standardized objective species-specific approach for the diagnosis of canine glomerular disease was needed. Eight veterinary pathologists evaluated 114 parameters (lesions) in renal biopsy specimens from 89 dogs. Hierarchical cluster analysis of the data revealed two large categories of glomerular disease, based on the presence or absence of immune complex deposition. The immune complex-mediated glomerulonephritis category included cases with a membranoproliferative or membranous pattern on histology. Non-immune complex mediated glomerulonephropathies included control dogs and dogs with glomerular amyloidosis or focal segmental glomerulosclerosis. Cluster analysis performed on only the LM parameters led to misdiagnosis of 22 of the 89 cases, i.e., ICGN cases moved to the non-ICGN branch of the dendrogram or vice versa, emphasizing the importance of advanced diagnostic modalities in the evaluation of canine glomerular disease. Salient LM, TEM and IF features for each pattern of disease were identified, and a preliminary investigation of related clinicopathologic data was performed.
In this study, 25 female and 15 male mongrel dogs, aged ranging from i to 7 years, were used. They were subjected to clinical, ultrasonographical and biochemical examinations. Ultrasonographically in 18 of the 40 do gs (45%), different kidney abnormalities were observed, whereas the other 22 dogs were found normaL. Likewise, serum urea and creatinine levels were measured to be higher in the dogs with kidney abnormalities. Serum creatinine elearance estimated using the Cockroft-Gault equation was exceeding the physiological range. In conelusion, for mongrel dogs ultrasonographic examination, measurements of serum urea nitrogen (BUN) and creatinine, and calculation of serum creatinine elearance using the Cockroft-Gault equation might be useful to diagnose early kidney abnormalities.
Urinary Markers in Early Diagnosis of Renal Disorders in Dogs
2016
Introduction Renal diseases are very common in dogs and as in humans; mortality rates have remained essentially unchanged at approximately 50-70% (Brunker et al., 2009) Traditional diagnostic markers such as blood urea nitrogen and serum creatinine will only be increased when already 75% of functional renal mass is lost (Clemo, 1999). Since there is a high risk of progression to irreversible renal damage in patients with chronic kidney disease, especially in a more advanced stage. But early diagnosis of decreased kidney function remains a challenge in veterinary medicine as diagnostic tests. Accessible markers of kidney injury can be components of serum or urine or can be imaging studies or any other quantifiable parameter. The urine has yielded the most promising markers for the early detection of disorder and further characterization is anticipated, which will qualify these markers as useful tools for the earlier diagnosis, identification of mechanism of injury, and assessment of ...
Urinalysis in dog and cat: A review
Veterinary World, 2020
Urinalysis is the examination of normal and abnormal constituents of urine. It is an easy, cheap, and vital initial diagnostic test for veterinarians. Complete urinalysis includes the examination of color, odor, turbidity, volume, pH, specific gravity, protein, glucose, ketones, blood, erythrocytes, leukocytes, epithelial cells, casts, crystal, and organisms. Semi-quantitative urine analysis with urine dipsticks, as well as an automatic analyzer, provides multiple biochemical data. Contamination is almost entirely avoided if the protocols for ensuring a proper sample have been followed, as mentioned still consideration must be given to the likelihood of contamination, even if the sample is correctly obtained. Interpretation of urinalysis will be doubtful if the knowledge of the interference is limited. Well-standardized urinalysis, when correlated in the context of history, clinical findings, and other diagnostic test results, can identify both renal and non-renal disease. This paper reviews significance of different components of urinalysis of dog and cat, such as collection, storage, examination, interpretation, and common causes of error in the result.
Histopathological retrospective study of canine renal disease in Korea, 2003~2008
Journal of Veterinary Science, 2010
Renal disease includes conditions affecting the glomeruli, tubules, interstitium, pelvis, and vasculature. Diseases of the kidney include glomerular diseases, diseases of the tubules and interstitium, diseases of renal pelvis, and developmental abnormalities. Renal tissue samples (n = 70) submitted to the Department of Veterinary Pathology of Konkuk University from 2003 to 2008 were included in this study. Tissue histopathology was performed using light microscopy with hematoxylin and eosin stains. Masson's trichrome, Congo Red, and Warthin starry silver staining were applied in several individual cases. Glomerular diseases (22.9%), tubulointerstitial diseases (8.6%), neoplastic diseases (8.6%), conditions secondary to urinary obstruction (24.3%), and other diseases (35.7%) were identified. Glomerulonephritis (GN) cases were classified as acute proliferative GN (5.7%), membranous GN (4.3%), membranoproliferative GN (4.3%), focal segmental GN (2.9%), and other GN (4.2%). The proportion of canine GN cases presently identified was not as high as the proportions identified in human studies. Conversely, urinary obstruction and end-stage renal disease cases were relatively higher in dogs than in human populations.
Acta cirúrgica brasileira / Sociedade Brasileira para Desenvolvimento Pesquisa em Cirurgia, 2012
Evaluate a new immobilization kidney method for collecting blind percutaneous renal biopsies (RB) in healthy cats. Ten cats were biopsied by a modified blinded percutaneous technique using semi-automated needles. Were evaluated the operational aspects of the technique, its complications, and the quality of the obtained samples. The evaluation included physical examination, hemogram, urinalysis, abdominal ultrasound, renal function, and histopathology of the biopsy specimens. The developed technique was fast and easy to perform; it required two operators, and the right kidney was elected for specimen collection. After the RB, a decrease in hematocrit levels was observed in addition to hematuria and perirenal transient hematoma; however, no clinical consequences were observed, and normal parameters were restored within 48 hrs. There were no major complications or deaths, alterations in the physical examination or renal function, or signs of infection. Of the samples, 95% revealed the ...