Abstract
Most people with acute kidney injury do not have a renal biopsy. Acute kidney injury is associated with acute abnormalities in tubules. Provided acutely abnormal tubules are not in an infarcted area of cortex, they may recover to normal. The most likely finding in renal biopsy specimens from adults with acute kidney injury is vasculitis. This almost always takes the form of vasculitic glomerulonephritis. Other common findings in acute kidney injury are various glomerular disorders, acute interstitial nephritis, tubular disorders such as light chain cast nephropathy, and thrombotic microangiopathy. Only if none of these identifiable conditions is found should the diagnosis be given as acute tubular damage not explained by anything in the biopsy specimen.
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Further Reading
D’Agati VD, Jennette JC, Silva FG. Non-neoplastic kidney diseases. Atlas of Nontumor Pathology, first series, fascicle 4. Washington: American Registry of Pathology and Armed Forces Institute of Pathology; 2005. Chapters 10-16, 18-22.
Jennette JC, Olson JL, Silva FG, D’Agati VD, editors. Heptinstall’s pathology of the kidney. 7th ed. Philadelphia: Wolters Kluwer; 2015. Chapters 14-20, 22, 25, 26.
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Howie, A.J. (2020). Indication for Biopsy: Acute Kidney Injury. In: Handbook of Renal Biopsy Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-40939-5_7
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DOI: https://doi.org/10.1007/978-3-030-40939-5_7
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