de Castro M C, Chocair P R, Saldanha L B, Nahas W, Arap S, Sabbaga E, Ianhez L E
Unidade de Transplante Renal, Faculdade de Medicina, Universidade de São Paulo.
Rev Assoc Med Bras (1992). 1998 Apr-Jun;44(2):155-8.
To assess the agreement between clinical and histopathological diagnosis in a renal transplantation center, 40 episodes of acute renal failure were studied.
Kidney biopsies were performed at the moment that a clinical diagnosis was made by the staff.
Nineteen episodes of acute tubular necrosis (ATN), eighteen episodes of acute cellular rejection (ACR), 2 humoral rejections and 1 acute cyclosporin nephrotoxicity episodes were diagnosed. ATN episodes were confirmed by renal biopsy in 84.21%, ACR episodes in 83.33%, humoral rejections in 100%. Renal biopsy showed ATN in the occurrence of clinical cyclosporin nephrotoxicity. Total agreement was 82.5%.
There is a good relationship between clinical and histopathological diagnosis in the post-transplantation period. Diagnostic mistakes occurred mainly when oliguria was present.