Autori: Matteo Righini, Marco Ruggeri
Affiliazioni: Unità operativa Nefrologia, Dialisi e Trapianto Prof.La Manna, Policlinico S.Orsola-Malpighi
Introduction: Electron microscopy (EM) has been routinaly used in the assessment of kidney diseases. The aim of our study was to evaluate the impact of EM in the setting of kidney biopsy as an important diagnostic tool in supporting or confuting light microscopy (LM) or immunofluorescence (IF).
Material and methods: A retrospective evaluation of 297 native and graft kidney biopsies was performed in our Institute from January 2015 to March 2018, in order to assess the impact of EM in the diagnosis of proper kidney disease.
Results: In our population, EM was performed in 108 biopsies (36.4%). In 76 cases (70,4%), EM confirmed the LM or IF, while in 32 cases (29,6%) was crucial to achieve the final diagnosis. The pivotal role was found in podocitopaties (12/32, 37,5%), other found were Membranous Nephropathy (4/32, 12,5%), Hypertensive lesion (4/32, 12,5%).
Conclusions: Even if in most cases, final diagnosis was reached only by LM or IF, almost one third of them were achieved through the fundamental evaluation of EM. In 32 cases (10,8% of the total population) EM confutes the previous diagnose
expressed only by LM or IF. Althought several diagnosis reached through ME are podocitopaties, ME add lots of elements that are crucial for almost every diagnose. Therefore we recommend to collect at least a sample of EM in every biopsy in order to be used everytime the diagnose is not perfectly clear.