How does the presence of the pathologist affect the tissue adequacy and what are the factors affecting the pathologist in proficiency assessment, during percutaneous kidney biopsy?

Abstract

Objectives: For optimal histomorphological examination, adequacy of kidney biopsy tissue
 should be obtained. In this study, the effect of a pathologist informing the radiologist about
 tissue adequacy during the biopsy procedure on obtaining tissue adequacy was examined.
 Furthermore, we aimed to determine the criteria that the pathologist considered in determining
 tissue adequacy and the conditions affecting the decision to increase the number of core
 biopsies, as these have not been previously examined in the literature.
 Materials and Methods: Tissues containing less than 10 glomeruli were considered
 inadequate. In some patients, a pathologist accompanied the radiologist during the procedure.
 Tissue adequacy ratios and biopsy sample numbers were calculated between the two
 conditions. In the samples taken with the pathologist, the factors affecting the locality
 decision of the pathologist (cortex/medulla amount, presence of glomerular pathology(global,
 segmental, crescentic glomeruli) presence of tubular injury, proteinuria; interstitial
 inflammation and interstitial fibrosis/tubular atrophy ratios, account of normal glomeruli)
 were examined.
 Results: Giving tissue adequacy information during the biopsy procedure had a positive
 effect on tissue adequacy. The amount of cortex is one of the qualification criteria for the
 pathologist. The presence of proteinuria and 50% or more inflammation in tissues with
 sufficient cortex increased the number of biopsy samples.
 
 Conclusion: Determination of tissue adequacy during kidney biopsy is an important and
 necessary method. The amount of cortex is one of the important parameters in tissue
 adequacy.