Equis ISSN 2398-2977

Kidney: biopsy

Synonym(s): Renal biopsy

Contributor(s): Simon Peek, Prof Susan Rhind

Introduction

  • Renal disease   Kidney: disease - overview  is uncommon in horses compared to other species.
  • Functional reserve of kidneys implies that bilateral severe disease must occur before outward signs of organ failure   Kidney: renal failure   occur (>70% nephron loss).
  • Ultrasound examination   Ultrasonography: abdomen  and guidance are obligate pre-requisites for renal biopsy.

Uses

  • Renal biopsy best indicated for histologic diagnosis of renal masses or investigation of azotemia or massive proteinuria with diffuse bilateral disease.
  • Biopsy can help target medical and surgical therapy of renal disease, eg steroidal anti-inflammatory drugs for glomerulonephritis, or nephrectomy for unilateral neoplasia   Kidney: renal carcinoma  or hydronephrosis.

Advantages

Disadvantages

  • Invasive procedure, which carries risk of renal hemorrhage or inadvertent gut penetration, hence the need for ultrasound guidance.
  • Assumes diffuse disease, although this is often the case for bilateral disease. For focal lesion(s), risk of false-negative result.
  • Biopsy of left kidney more challenging than right due to anatomy - right kidney is adjacent to body wall, left kidney frequently only accessible through spleen.
  • Advisable to check clotting function prior to procedure (PT and PTT)   Blood: hemostasis  .
  • Ensure recent tetanus prophylaxis   Tetanus antitoxin  .

Requirements

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Preparation

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Procedure

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Aftercare

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Tyner G A et al (2009) Renal biopsies in horse; a retrospective study of 71 cases. J Vet Intern Med 23 (3), 703.
  • Barratt-Boyes S M et al (1991) Ultrasound localization and guidance for renal biopsy in the horse. Vet Radiol 32 (3), 121-126 VetMedResource.


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