Gonzalez Fernando M, Valjalo Ricardo
Department of Nephrology, Faculty of Medicine, Universidad de Chile, Santiago 7500922, Chile.
Department of Nephrology, Hospital del Salvador, Santiago 7500922, Región Metropolitana, Chile.
World J Nephrol. 2025 Jun 25;14(2):103756. doi: 10.5527/wjn.v14.i2.103756.
The discussion on renal biopsies and biomarkers highlights the essential aspects of nephrology. Although novel diagnostic biomarkers are emerging, renal biopsy remains critical for accurate diagnosis and treatment owing to the lack of sufficiently validated biomarkers with high sensitivity and specificity. Puspitasari highlighted the significant changes in renal biopsy indications and histological outcomes before and after the coronavirus disease 2019 (COVID-19) pandemic, reflecting the complex interactions between clinical workflows, public health issues, and patient demographics. Although biomarkers are increasingly utilized in nephrology, their importance remains balanced with traditional practices. Advancements in precision medicine are exemplified by tests like plasma anti-phospholipase A2 receptor levels. However, the COVID-19 pandemic revealed significant vulnerabilities in nephrology services, emphasizing the necessity for adaptable and robust healthcare strategies to manage chronic conditions during global crises. In conclusion, while biomarkers are poised to assume a more prominent role in nephrology, the significance of renal biopsies and thorough histopathological analysis remains paramount in understanding complex disease processes and guiding personalized patient management. The ongoing integration of traditional diagnostic approaches with innovative biomarker strategies promises to improve patient care and long-term health outcomes.
关于肾活检和生物标志物的讨论突出了肾脏病学的重要方面。尽管新的诊断生物标志物不断涌现,但由于缺乏足够多经过充分验证的高灵敏度和特异性生物标志物,肾活检对于准确诊断和治疗仍然至关重要。普斯皮塔萨里强调了2019冠状病毒病(COVID-19)大流行前后肾活检指征和组织学结果的显著变化,这反映了临床工作流程、公共卫生问题和患者人口统计学之间的复杂相互作用。尽管生物标志物在肾脏病学中的应用越来越广泛,但其重要性仍与传统做法保持平衡。精准医学的进展以血浆抗磷脂酶A2受体水平检测为例。然而,COVID-19大流行揭示了肾脏病服务中存在的重大漏洞,强调了在全球危机期间制定适应性强且稳健的医疗保健策略以管理慢性病的必要性。总之,虽然生物标志物在肾脏病学中有望发挥更突出的作用,但肾活检和全面的组织病理学分析在理解复杂疾病过程和指导个性化患者管理方面的重要性仍然至关重要。传统诊断方法与创新生物标志物策略的持续整合有望改善患者护理和长期健康结局。