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Percutaneous renal graft biopsy: a clinical, laboratory and pathological analysis
M Mazzali1, M A Ribeiro-Alves, G Alves Filho
1Departamento de Clínica Médica, Faculdade de Ciências Médicas-Universidade Estadual de Campinas, Brazil. m_mazzali@hotmail.com
Context:
Renal allograft biopsies have been used as a good method for monitoring the evolution of kidney transplants for at least 20 years. Histological analysis permits differential diagnosis of the causes of allograft dysfunction to be made.
Objectives:
To correlate the data of urinalysis and serum creatinine with histological diagnosis of renal graft in a group of renal transplant patients.
Design:
Accuracy study, retrospective analysis.
Setting:
A university terciary referral center.
Sample:
339 percutaneous allograft biopsies obtained from 153 patients. Blood and urine samples were obtained before the graft biopsy.
Main Measurements:
Laboratory evaluation and hystological analysis (light microscopy, immunofluorescent electronic microscopy).
Results:
Most of the biopsies (58.9%) were performed during the first month post-transplant. An increase in serum creatinine was associated with acute tubular and/or cortical necrosis. Proteinuria and normal serum creatinine were associated with glomerular lesions. Non-nephrotic range proteinuria and an increase in serum creatinine were associated with chronic rejection.
Conclusion:
Evaluation of serum creatinine and urinalysis can be useful in suggesting the histological graft diagnosis.