Abstract: TH-PO803
On-Site Evaluation of Renal Biopsy Specimens: Impact on Diagnostic Yield in the Absence of Nephropathologists
Session Information
- Pathology and Lab Medicine - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Ekiz, Esra, Harlem Hospital Center, New York, New York, United States
- Mu'Amar, Tariq Abdel Ra'Uof Qasim, Harlem Hospital Center, New York, New York, United States
- Andrabi, Suhaib A., Harlem Hospital Center, New York, New York, United States
- Herbert, Leroy, Harlem Hospital Center, New York, New York, United States
Background
Renal biopsy is a crucial procedure for diagnosing kidney diseases, and the quality of obtained tissue samples is essential for accurate diagnosis. On-site evaluation of biopsy specimens has been shown to increase the diagnostic yield. However, there is a trend of omitting on-site assessment when a nephropathologist is not readily available, leading to decreased yield. We hypothesized that evaluation of biopsy specimens by a nephrologist en-suite would improve specimen adequacy in the absence of a pathologist.
Methods
Electronic medical records of patients who underwent kidney biopsy from 2019 to 2022 were reviewed. Demographic, clinical, and biopsy-related data were collected. Biopsy specimens were evaluated by a nephrologist on-site, and the final pathology report was provided by different pathologists. Adequacy of the specimens was assessed based on the number of glomeruli observed under light microscopy, immunofluorescence, and electron microscopy.
Results
The average age of the study sample was 50, range between 20-72 years of age. 19 of all patients were women. 5 out of 30 biopsies were performed under CT-guidance. Adequate number of glomeruli were found in 27 biopsies; 2 of them had 6 glomeruli in LM, the other had a total of 3 glomeruli. A minimum of 1 glomerulus was available for IF and EM. 2 specimen were deemed adequate by ephrologist but inadequate by patholgist. 1 specimen was deemed inadequate by both nephrologist and pathologist. Average glomerular yield was 26. Median glomerular yield was 40 glomeruli total. The most common pathologic diagnoses were secondary FSGS and diabetic nodular glomerulosclerosis.
Conclusion
Adequate biopsy samples are crucial for accurate diagnosis and monitoring of kidney disorders. Previous studies have shown that on-site assessment of biopsy specimens improves yield outcomes. In this study, evaluation of specimens by a nephrologist en-suite showed nearly 100% correspondence with pathologists' assessments. Our findings suggest that nephrologists' evaluation of gross biopsy specimens can positively impact biopsy yield in institutions lacking nephropathologists. Further research with larger cohorts is needed to validate these findings and assess the generalizability of this approach.