What is the role of kidney biopsy in the workup for chronic glomerulonephritis?

Updated: Feb 24, 2020
  • Author: Moro O Salifu, MD, MPH, FACP; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

If the kidney is small, kidney biopsy is usually unnecessary; no specific pattern of disease can be discerned at this point. A kidney biopsy may be considered in the minority of patients who exhibit an acute exacerbation of their chronic disease. This may be particularly pertinent to patients with preserved kidney size and in those with lupus nephritis.

In early stages, the glomeruli may still show some histologic evidence of the primary disease. In advanced stages, the glomeruli are hyalinized and obsolescent. The tubules are disrupted and atrophic, and marked interstitial fibrosis and arterial and arteriolar sclerosis occur.

A study by Murray et al of 75 patients with suspected familial kidney disease who underwent genetic sequencing after kidney biopsy found that accurate genetic diagnosis can result in changes in clinical diagnosis, understanding of pathological mechanism, and treatment. These authors recommended considering next-generation sequencing as a complement to kidney biopsy in the evaluation of patients with kidney disease. [27]


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