In the process of kidney disease’s diagnosis, kidney biopsy is nearly the final step, which can help the doctor get the more accurate pathological judgment, thus patients can design the more detailed and correct treatment options. In some hospital, the test is a must to determine pathological type when patients have kidney disease. Then, question comes: Must kidney biopsy be reliable?
Now, let’s see an example.
Xiaobo was diagnosed with acute kidney failure due to swelling in legs. Aside from hormones treatment, cyclophosphamide and LeiGong teng, he also accepted dialysis (twice a week). But after week, creatinine level cannot be lowered, in turn, it still keep increasing. Then, he came to another hospital. At the time, the doctor suggested him to kidney puncture (kidney biopsy). The pathological report showed “non-typical membrane proliferative glomerulonephritis (crescent III type)” and he was diagnosed with “Hepatitis b virus associated membrane proliferative glomerulonephritis” after the test, the illness condition also had no any improvements.
Kidney biopsy is not always reliable.
When he came to our hospital-Shijiazhuang Kidney Disease Hospital, we found several doubts according to his test reports.
1.The patient is the HBV carrier, but the hepatitis b virus is not reproduced. And in immunofluorescence, the doctor do not the dyeing of hepatitis b virus. As a result, we do not find out the HBV. Therefore, hepatitis b virus associated kidney disease is a wrong diagnosis.
2. The pathological report showed that patient is the “Crescent III type” which means there is just no or small amount of immune complexes. But the test showed clearly that a large amount of immune complexes deposit in the kidneys. Therefore, we considered that patient is the “crescent II type”.
3. Immunofluorescence showed that IgA is strong positive, but other antibodies are positive or weak positive. Therefore, we get the diagnosis: the patient is a acute glomerulonephritis, acute Kidney Failure caused by IgA Nephropathy
After getting correct diagnosis and effective treatments, the creatinine level has reduced to 450umol/L from 1041umol/L.
Don’t believe the kidney puncture blindly.
Kidney biopsy is just one of test measurement. Although it can be helpful to decide the pathological type, it also usually can be a liar.
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