Impact of kidney biopsy on the management of patients in the rheumatology department: retrospective study

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Abstract

Background. Kidney involvement is a common manifestation of the systemic autoimmune rheumatic diseases. Kidney biopsy is the “gold standard” for the diagnosis of kidney diseases, however this method has not yet become the standard-of-care in rheumatology practice.

Aim. To assess the diagnostic value of kidney biopsy in the management of patients of the rheumatology department.

Materials and methods. In this retrospective observational study we analyzed the medical documentation including kidney morphology findings in the patients of the Department of Rheumatology at Tareev Clinic of Internal Diseases. All patients included in the research had signs of kidney involvement and had undergone needle biopsy of the kidney or re-evaluation of the kidney tissue received previously.

Results. From June 2016 to October 2021, 3110 patients were admitted to the rheumatology department. Among them 63 (2%) underwent kidney biopsy and were included in the study. Twenty (32%) were male. Mean age was 42.5±13.9 years. The most common preliminary diagnoses before kidney biopsy were ANCA-associated vasculitis (n=17), systemic lupus erythematosus (n=12), and AA-amyloidosis associated with inflammatory joint diseases (n=7). In 14 (27%) patients diagnosis was unspecified at the time of biopsy. Among 49 patients with established preliminary diagnosis morphological findings were in line 38 (78%) with the pre-liminary diagnosis. However, in 11 (22%) patients morphological findings resulted in the change of the diagnosis. In all 14 patients with unspecified condition kidney biopsy helped to establish clinical diagnosis. Ultrasound evaluation demonstrated hematoma formation in 18 (31%) patients, and among them two required blood component transfusions.

Conclusion. Our study demonstrates significant value and safety of kidney biopsy in the patients with autoimmune rheumatic conditions. We suggest that kidney biopsy should be implemented in the management of this category of patients.

About the authors

Valeria A. Kokhanchuk

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0003-1827-1100

студентка Клинического института детского здоровья им. Н.Ф. Филатова

Russian Federation, Moscow

Alexey V. Skvortsov

Lomonosov Moscow State University

Email: nmbulanov@gmail.com
ORCID iD: 0000-0001-8743-5207

ординатор каф. внутренних болезней фак-та фундаментальной медицины

Russian Federation, Moscow

Elena M. Shchegoleva

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-6364-4722

врач-ревматолог ревматологического отд-ния Клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева, ассистент каф. внутренних, профессиональных болезней и ревматологии

Russian Federation, Moscow

Ekaterina I. Kuznetsova

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-7857-6320

врач-ревматолог ревматологического отд-ния Клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева

Russian Federation, Moscow

Pavel I. Novikov

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0003-0148-5655

канд. мед. наук, зав. ревматологическим отд-нием Клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева

Russian Federation, Moscow

Ekaterina S. Stoliarevich

Yevdokimov Moscow State University of Medicine and Dentistry

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-0402-8348

д-р мед. наук, проф. каф. нефрологии

Russian Federation, Moscow

Vladimir A. Varshavsky

Sechenov First Moscow State Medical University (Sechenov University)

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-5855-3092

врач-патологоанатом централизованного патологоанатомического отд-ния

Russian Federation, Moscow

Sergey V. Moiseev

Sechenov First Moscow State Medical University (Sechenov University); Lomonosov Moscow State University

Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-7232-4640

акад. РАН, д-р мед. наук, проф., проф. каф. внутренних, профессиональных болезней и ревматологии Института клинической медицины им. Н.В. Склифосовского, дир. Клиники ревматологии, нефрологии и профпатологии им. Е.М. Тареева Университетской клинической больницы №3, проф. каф. внутренних болезней фак-та фундаментальной медицины

Russian Federation, Moscow; Moscow

Nikolay M. Bulanov

Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: nmbulanov@gmail.com
ORCID iD: 0000-0002-3989-2590

канд. мед. наук, доц. каф. внутренних, профессиональных болезней и ревматологии, зам. дир. Института клинической медицины по учебной и клинической работе

Russian Federation, Moscow

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