Renal Biopsy: History and Perspectives

Renal biopsy (RB) is a valuable diagnostic tool. This review discusses RB used in Russia in research and practice since the 1980s. Among others the role of RB in the following conditions is analyzed: glomerulo- and pyelonephritis, arterial hypertension, alcoholism, diabetes mellitus and urinary tract malformations in children. The material used in certain studies was unique: wedge or core biopsies in hydronephrosis, acute and chronic pyelonephritis. Collection of RBs was associated with risk, in particular, intra-operative biopsies in acute pyelonephritis and hydronephrosis. Morphological overdiagnosis of mesangioproliferative glomerulonephritis resulted in the overtreatment with steroids and cytostatica in some cases. The main conclusion is that, considering possible adverse effects, RB for research should not existas such; it must always be performed according to clinical indications. If a patient gives informed consent to research on renal tissue obtained for diagnostic purposes, it can be done, provided that enough tissue remains for the diagnostics.