Percutaneous renal graft biopsy: a clinical, laboratory and pathological analysis

RESUMO

Renal allograft biopsies have been used as a good method for monitoring the evolution of kidney transplants for at least 20 years. Histological analysis permits differential diagnosis of the causes of allograft dysfunction to be made. Objectives: To correlate the data of urinalysis and serum creatinine with histological diagnosis of renal graft in a group of renal transplant patients. Design: Accuracy study, retrospective analysis. Setting: A university terciary referral center. Sample 339 percutaneous allograft biopsies obtained from 153 patients. Blood and urine samples were obtained before the graft biopsy. Main Measurements Laboratory evolution and hystological analysis (light microscopy, imunofluorescent eletronic microscopy). Results: Most of the biopsies (58.9 per cent) were performed during the first month post-transplant. An increase in serum creatinine was associated with acute tubular and/or cortical necrosis. Proteinuria and normal serum creatinine were associated with glomerular lesions. Non-nephrotic range proteinuria and an increase in serum creatinine were associated with chronic rejection. Conclusion: Evaluation of serum creatinine and urinalysis can be useful in suggesting the histological graft diagnosis.