A practical approach to the diagnosis of renal disease by biopsy

The pathologist has an important role in the diagnosis and monitoring of renal disease. However, for optimal useful information to be derived from renal biopsy specimens, certain guidelines must be adhered to and these are enunciated here. The 3 avenues of observation of renal biopsies viz. light microscopy, immunofluorescence and electron microscopy, all have important roles to play and give differing data which informs the diagnosis for the renal biopsy report. The relative emphasis on each of these modalities of investigation will vary depending upon the situation in which the renal biopsy is performed. The methods used here have been shown to be effective in practice over a period of 20 yrs. Although there may be variations in methodology from centre to centre, the general background aims and principles remain the same. The emphasis in this paper has been on common practical aspects of renal biopsies. Much of the practical information concerning renal biopsies, which is brought together here, is otherwise scattered and not readily available. The aim of this article is to allow the reader to understand the rationale for the steps that are involved in renal biopsy diagnosis.