Renal biopsy: A 9-year study at an osteopathic referral center

In a series of 176 consecutive renal biopsies in 168 patients (From January 1973 to January 1982) the clinical, etiologic, and histologic features were reviewed and compared to previous renal biopsy reports. Nephrotic syndrome was the most frequent indication for renal biopsy (32 percent) followed by suspected lupus nephritis (16 percent), asymptomatic hematuria (11 percent), asymptomatic proteinuria (10 percent), asymptomatic hematuria and proteinuria (9 percent), and rapidly progressive renal failure (9 percent). Idiopathic glomerulopathies comprised 64 percent of the series in which the most common histologic lesions consisted of focal glomerulonephritis and membranous nephropathy. Lupus nephropathy was the most frequent disease encountered in the secondary renal diseases (15 percent). Adequate renal tissue for diagnosis was obtained in 96 percent of the percutaneous biopsy attempts with fluoroscopic guidance slightly superior (98 percent) to the ultrasonic guidance method (88 percent). Only five clinically significant complications occurred with the percutaneous method, resulting in a complication rate of 3 percent. It is concluded that in a renal biopsy series performed at an osteopathic medical center, the clinical presentation of patients, histologic features, retrieval of tissue, and complication rate is comparable to previously reported large biopsy series from allopathic medical centers. This study also showed a higher incidence of IgA nephropathy (Berger's disease), heretofore unrecognized.