Nephrectomy (kidney) Biopsy

Biopsy

Report in 240Hrs

At Home

No Fasting Required

Details

Histopathology of kidney removal.

₹888₹1,269

30% OFF

Nephrectomy (Kidney) Biopsy - Comprehensive Medical Test Information Guide

Why is it done?
- Test Description: A nephrectomy biopsy involves the surgical removal of kidney tissue or, in cases of complete nephrectomy, removal of the entire kidney. Histopathological examination of the tissue is performed to identify malignancies, assess kidney damage, or evaluate disease processes.
- Primary Indications: Suspected renal cell carcinoma or other malignancies; Diagnosis of cystic kidney diseases; Evaluation of chronic kidney disease with unknown etiology; Assessment of transplanted kidney rejection; Investigation of persistent hematuria; Evaluation of renal masses of uncertain nature
- Timing and Circumstances: Performed when imaging studies reveal suspicious renal masses; Indicated after failure of conservative management; Undertaken when definitive diagnosis is required for treatment planning; Pursued when recurrent or progressive kidney pathology requires characterization
Normal Range
- Normal Findings: Absence of malignant cells; Normal glomerular architecture; Intact tubular epithelium; Normal interstitial tissue without fibrosis; Absence of inflammatory infiltrates; Preserved basement membrane integrity
- Normal Microscopic Features: Well-preserved renal parenchyma; Normal glomerular filtration barrier; Clear demarcation between cortex and medulla; Absence of necrosis or apoptosis; No abnormal deposits on immunofluorescence microscopy
- Result Classification: Benign/Negative - No malignancy or significant pathology detected; Abnormal/Positive - Presence of malignancy, significant inflammation, or disease process identified; Inconclusive - Insufficient tissue or equivocal findings requiring repeat sampling or additional studies
- Units of Measurement: Histological grading (e.g., Fuhrman nuclear grade for renal cell carcinoma ranging from Grade 1-4); TNM staging for malignancies; Descriptive pathological reporting based on morphological findings
Interpretation
- Benign Lesions: Oncocytoma, angiomyolipoma, or renal cortical adenoma - Indicates non-malignant pathology; No aggressive disease; May require follow-up imaging or conservative management depending on lesion characteristics
- Renal Cell Carcinoma (RCC): Clear cell RCC - Most common subtype (70-80%); Fuhrman Grade 1-2 indicates favorable prognosis; Grade 3-4 suggests aggressive behavior; Indicates need for radical or partial nephrectomy
- Inflammatory/Infectious Findings: Presence of granulomas, abscess formation, or specific organisms (fungal, mycobacterial); Indicates need for targeted antimicrobial therapy; Determines duration and type of treatment required
- Chronic Kidney Disease Patterns: Glomerulosclerosis, tubular atrophy, and interstitial fibrosis - Staging ranges from minimal to advanced fibrosis; Determines reversibility of kidney dysfunction; Guides intensity of immunosuppressive therapy if applicable
- Transplant Rejection: Acute cellular rejection shows lymphocyte infiltration and tubulitis; Antibody-mediated rejection demonstrates C4d deposition; Chronic rejection exhibits arterial fibrointimal proliferation; Classification determines therapeutic intervention and immunosuppressive adjustments
- Factors Affecting Interpretation: Tissue quality and specimen adequacy; Presence of crush artifact or thermal injury from biopsy technique; Fixation and processing artifacts; Number and size of tissue samples obtained; Immunohistochemical and genetic studies availability
- Clinical Significance: Results directly influence treatment decisions including surgery, chemotherapy, targeted therapy, or immunotherapy; Prognosis determination based on tumor grade and stage; Monitoring response to therapy; Planning surveillance protocols
Associated Organs
- Primary Organ System: Urinary/Renal system - Kidneys perform filtration, electrolyte regulation, and blood pressure control; Bilateral organs with redundant function; Loss of kidney function has systemic metabolic consequences
- Related Organ Systems: Vascular system - Renal artery and vein involvement in malignancy or thrombosis; Lymphatic system - Regional lymph node involvement in metastatic disease; Endocrine system - Altered renin-angiotensin-aldosterone system with kidney loss; Bone marrow - Production of erythropoietin regulated by kidney function
- Common Diagnoses Associated with Abnormal Results: Renal cell carcinoma (clear cell, papillary, chromophobe, or sarcomatoid subtypes); Pyelonephritis and perinephric abscess; Glomerulonephritis and lupus nephritis; Diabetic nephropathy; Polycystic kidney disease; Renal infarction; Tuberculosis of kidney; Oncocytoma and other benign tumors
- Potential Complications of Abnormal Results: Metastatic disease spread affecting lungs, bones, and liver; Progressive renal failure requiring dialysis or transplantation; Hypertension from kidney pathology or loss of renal mass; Anemia from reduced erythropoietin production; Metabolic acidosis and electrolyte imbalances; Uremic syndrome with systemic complications
- Surgical Complications Associated with Nephrectomy: Hemorrhage and vascular injury; Infection and sepsis; Ureteral injury during dissection; Pancreatic or splenic damage; Acute kidney injury in remaining kidney; Chronic disease in solitary remaining kidney
Follow-up Tests
- Staging and Metastatic Workup: Chest CT or chest X-ray to assess for pulmonary metastases; Abdominal/pelvic CT with contrast to identify lymph node involvement; Bone scan or PET-CT for skeletal metastases; Brain MRI if symptoms suggestive of central nervous system involvement
- Renal Function Assessment: Serum creatinine measurement; Estimated glomerular filtration rate (eGFR) calculation; Blood urea nitrogen (BUN) levels; Urinalysis and 24-hour urine protein; Electrolyte panels (sodium, potassium, chloride, bicarbonate); Baseline kidney function assessment if anticipating chemotherapy
- Molecular and Genetic Testing: VHL gene mutation analysis for RCC prognosis; Immunohistochemical markers (HIF-1α, carbonic anhydrase IX); FISH analysis for chromophobe RCC; Microsatellite instability testing; Programmed death ligand-1 (PD-L1) expression for immunotherapy eligibility
- Surveillance and Monitoring Tests: CT imaging every 3-6 months for first 2 years if high-grade malignancy; Annual imaging for 5 years post-nephrectomy; Renal ultrasound or contrast-enhanced CT to monitor remaining kidney; Follow-up creatinine and kidney function tests at 1, 3, and 6 months then annually; Serum alpha-fetoprotein or tumor markers if applicable
- Complementary Diagnostic Tests: Repeat renal biopsy if initial results inconclusive; Blood cultures if infection suspected; Immunological studies for lupus nephritis or vasculitis; Flow cytometry if lymphoproliferative disorder suspected; Electron microscopy for glomerular disease characterization
- Treatment Response Monitoring: Imaging studies 8-12 weeks after initiating therapy; Tumor marker levels during chemotherapy or immunotherapy; Kidney function tests during targeted therapy; Assessment of adverse effects and tolerance to treatment agents
Fasting Required?
- Fasting Status: YES - Fasting required 6-8 hours prior to procedure (typically overnight fast from midnight).
- Food and Fluid Restrictions: No solid foods after midnight before procedure; Clear liquids (water, black coffee or tea without additives) may be permitted up to 2-4 hours prior; Confirm specific fasting instructions with surgical team; NPO (nothing by mouth) status maintained until anesthesia clearance obtained
- Medications to Adjust or Avoid: DISCONTINUE 5-7 days prior: Aspirin, NSAIDs (ibuprofen, naproxen), warfarin, and antiplatelet agents due to bleeding risk; HOLD morning of procedure: Most regular medications with small sip of water as directed; ACE inhibitors or ARBs may be held day of surgery at surgeon's discretion; Diabetic medications held until post-procedure glucose levels established; Anticoagulants managed per hematology/cardiology guidelines for individual patient risk stratification
- Additional Pre-procedure Preparation: Bowel preparation may be ordered (typically polyethylene glycol solution) 24 hours before; Complete pre-operative laboratory studies (CBC, CMP, coagulation studies, type & crossmatch); Imaging studies (CT or ultrasound) completed and available in operative suite; Anesthesia consultation completed with assessment of comorbidities; Informed consent documentation reviewed and signed; Report to hospital 1-2 hours prior to scheduled procedure
- Day-of-Procedure Instructions: Void bladder immediately before pre-op medications; Wear identification bracelet with allergy information; Remove dentures, contact lenses, jewelry, and prosthetics; Wear hospital gown provided; Empty bladder catheterization may be performed; Void any pre-operative medications or enema as ordered; Have responsible adult for transportation post-procedure due to anesthesia effects
- Post-procedure Requirements: NPO status maintained until fully awake and tolerating oral intake; Advance diet gradually starting with clear liquids; Resume regular medications per surgical team instructions; Pain management with prescribed analgesics; Monitor for complications including fever, hematuria, or flank pain; Activity restrictions for 4-6 weeks post-operatively; Follow-up appointment scheduled within 2 weeks

How our test process works!