1. Chronic Kidney disease with normal sized kidney
2. Nephrotic syndrome in adults
3. Nephrotic syndrome in children with atypical features
Select the correct answer using the code given below:
Renal Biopsy Indications Explained
A renal biopsy is a procedure to diagnose kidney problems. It involves taking a small sample of kidney tissue for examination under a microscope.
The indications for performing a renal biopsy are evaluated based on specific clinical scenarios:
- Chronic Kidney Disease (CKD) with normal-sized kidneys: While small, shrunken kidneys often indicate irreversible disease, normal-sized kidneys in CKD can suggest an active underlying inflammatory or specific disease process (like certain glomerulonephritides) that might still be amenable to treatment. Therefore, biopsy is indicated to determine the specific cause and guide therapy.
- Nephrotic Syndrome in Adults: Nephrotic syndrome (characterized by heavy proteinuria, edema, hypoalbuminemia, and hyperlipidemia) in adults often requires a biopsy. This is because primary glomerular diseases (like FSGS, membranous nephropathy) and secondary causes (like lupus nephritis, amyloidosis, diabetic nephropathy) are more common than in children, and histological diagnosis is crucial for appropriate management.
- Nephrotic Syndrome in Children with atypical features: Most childhood nephrotic syndrome cases are Minimal Change Disease (MCD), which usually responds to steroids. However, if the syndrome presents with atypical features such as steroid resistance, persistent hematuria, hypertension, or impaired renal function (especially after 8-12 weeks of steroid therapy), a biopsy is recommended to rule out other conditions like Focal Segmental Glomerulosclerosis (FSGS) or other glomerulonephritides.
Based on these points, all three scenarios listed are valid indications for a renal biopsy.
Important Questions from Nephrotic Syndrome
A 40-year-old female with nephritic range proteinuria is found to have low serum complement levels. Which of the following can be the likely etiology?
1. Systemic lupus erythematosus
2. Post-infectious glomerulonephritis
3. Infective endocarditis
4. Mesangio-capillary glomerulonephritis
Select the correct answer using the code given below:
- All of the following conditions are associated with Glomerulonephritis with low complement level, EXCEPT:
- Presence of Dysmorphic Erythrocytes in urine analysis is suggestive of:
- Of all the types of lupus nephritis, the worst outcome is seen in:
Match list I with list II and select the correct answer using the code given below the lists:
List I (Urine exam) List II (Disease) A. Red cell casts 1. Nephrotic syndrome B. Microscopic haematuria 2. Chronic renal failure C. Proteinuria 3. Polycystic kidney disease D. Broad cell casts 4. Glomerulonephritis
