title: Biopsy of small kidneys: A safe and a useful guide to potentially treatable kidney disease.
abstract: Over the past four years, all patients with unexplained rapid progression of their renal disease were subjected to kidney biopsy, despite their small size (<9 cm), to define its etiology. Children, pregnant women, morbidly obese patients, and those with an unstable cardiovascular state, septicemia, bleeding diathesis as well as those kidney size with size <6 cm were excluded from the study. Doppler ultrasound was used to exclude renovascular/ischemic nephropathy. The procedure was performed by an interventional radiologist using a biopsy gun technique and under ultrasound guidance. The actual diagnosis was established in 29 cases while seven had advanced sclerosing glomerulonephritis. Eleven cases had evidence of vasculitis, of which two were due to polyarteritis nodosa and two were due to crescentic immunoglobulin A disease. The remaining patients had a secondary form of focal segmental glomerulosclerosis (n = 4), interstitial nephritis (n = 4), malignant nephro-angiosclerosis (n = 2), and single patient with primary hyperoxaluria, light chain cast nephropathy, amyloidosis, and thrombotic microangiopathy. All, except eight with advanced glomerulosclerosis, had improved or became stable with specific treatment. Our study shows that biopsy of small-sized kidneys, in patients with unexplained renal deterioration, is safe, and its diagnostic value can improve their morbidity and even mortality.
authors.affiliation: Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
authors.forename: Kamel
authors.initials: K
authors.lastname: El-Reshaid
authors.affiliation: Department of Medicine, Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
authors.forename: Wael
authors.initials: W
authors.lastname: El-Reshaid
authors.affiliation: Department of Medicine, Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
authors.forename: Dalal
authors.initials: D
authors.lastname: Al-Bader
authors.affiliation: Department of Radiology, Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Varro
authors.affiliation: Department of Pathology, Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
authors.forename: John
authors.initials: J
authors.lastname: Madda
authors.affiliation: Department of Medicine, Al-Amiri Hospital, Ministry of Health, Kuwait City, Kuwait.
authors.forename: Hosameldin Tawfik
authors.initials: HT
authors.lastname: Sallam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D011379:Prognosis; D018608:Ultrasonography, Doppler; D055815:Young Adult