Related Experiment Video
Updated: Aug 15, 2025
09:43
Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
Published on: June 8, 2022
3.0K
Renal biopsy in systemic infections: expect the unexpected
Bangchen Wang1, Alexandra Grand2, Micah Schub2
1Department of Pathology, Duke University Health Systems, Durham, NC, USA.
Ultrastructural Pathology
|January 5, 2023
Summary
Infection-related glomerulonephritis can be challenging to diagnose, especially with unusual infections. Renal biopsies can reveal systemic infections, guiding crucial treatment decisions for better patient outcomes.
Area of Science:
- Nephrology
- Infectious Diseases
- Pathology
Background:
- Infection-related glomerulonephritis (IRGN) is a recognized cause of kidney injury during active infections.
- Diagnosis can be delayed if the causative infection is uncommon or subclinical.
- Renal biopsy is a critical diagnostic tool for identifying IRGN and associated systemic infections.
Observation:
- Case 1: An 84-year-old male with IgA vasculitis and acute kidney injury (AKI) showed IgA deposits on renal biopsy, prompting COVID-19 detection.
- Case 2: A kidney transplant recipient with granulomatosis with polyangiitis (GPA) developed AKI; renal biopsy suggested herpes simplex virus (HSV)-related IRGN.
- Case 3: A 78-year-old female with AKI and positive p-ANCA had unusual IgM deposits on biopsy, leading to the diagnosis of Bartonella endocarditis.
Findings:
- Renal biopsy findings in IRGN exhibit diverse histological patterns.
- Immune complex deposition patterns (IgA, IgG, C3, IgM) vary based on the underlying infection.
- Biopsy results can guide targeted infectious disease workups, even in atypical presentations.
Implications:
- Recognizing the varied presentations of IRGN is crucial for timely diagnosis and management.
- Renal biopsies play a pivotal role in uncovering occult systemic infections.
- Early identification of infection-related kidney disease improves patient prognosis and treatment strategies.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
28
Introduction:For diagnosing acute pyelonephritis, a comprehensive patient history is collected to identify symptoms such as dysuria, frequent or urgent urination, flank pain, or costovertebral angle (CVA) tenderness that may suggest a kidney infection.Physical ExaminationDuring the physical examination, CVA tenderness is assessed. This involves gentle percussion over the costovertebral angle, where tenderness often indicates a kidney infection.Diagnostic TestsUrinalysis: Used to identify white...
28
01:30Acute Kidney Injury IV: Diagnostic Studies and Prevention
53
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
53
01:26Kidney Transplant II: Surgical Procedure
49
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living...
49
01:27Acute Pyelonephritis I: Introduction
31
Pyelonephritis is a bacterial infection that primarily affects the renal parenchyma and collecting system, including the renal pelvis, tubules, and interstitial tissue of one or both kidneys. It can be classified as either acute—a sudden, severe infection—or chronic, which refers to long-term or recurrent kidney infections.The primary cause of acute pyelonephritis (APN) is bacterial infection, with Escherichia coli accounting for approximately 70-80% of cases. Other bacteria, such...
31
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
23
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
23
01:16Kidney Transplant III: Nursing Management
56
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
56