Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington.
Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee.
Am J Kidney Dis. 2022 Jul;80(1):119-131. doi: 10.1053/j.ajkd.2021.08.024. Epub 2022 Feb 4.
The kidney biopsy is an essential tool for diagnosis of many kidney diseases. Obtaining an adequate biopsy sample with appropriate allocation for various studies is essential. Nephrologists should understand key lesions and their interpretation because these are essential elements underlying optimal approaches for interventions. This installment in the AJKD Core Curriculum in Nephrology will review these topics. We will first briefly discuss considerations for allocation and processing of kidney biopsies. We will then present in outline form the differential diagnoses of a spectrum of patterns of injury and consideration for interpretation of specific lesions. Lesions are presented according to anatomic site as glomerular, vascular, or tubulointerstitial. Native and transplant kidney biopsy lesions are included. These lesions and differential diagnoses and specific diseases are then linked to detailed clinicopathologic discussion of specific diseases presented in the AJKD Atlas of Kidney Pathology II. Correlation with immunofluorescence, electron microscopy, and clinical findings are emphasized to reach a differential diagnosis and the final diagnosis.
肾活检是诊断许多肾脏疾病的重要工具。获取足够的活检样本并进行适当的分配以供各种研究是至关重要的。肾病学家应该了解关键病变及其解释，因为这些是干预的最佳方法的基本要素。本期 AJKD 肾脏病学核心课程将回顾这些主题。我们将首先简要讨论肾活检的分配和处理注意事项。然后，我们将以大纲形式呈现一系列损伤模式的鉴别诊断，并考虑特定病变的解释。病变根据解剖部位分为肾小球、血管或肾小管间质。包括原发性和移植肾活检病变。然后将这些病变和鉴别诊断以及特定疾病与 AJKD 肾脏病病理学图谱 II 中呈现的特定疾病的详细临床病理讨论联系起来。强调与免疫荧光、电子显微镜和临床发现的相关性，以达到鉴别诊断和最终诊断。
