Specialized testing and a depth of expertise are needed to support accurate and comprehensive diagnoses of the range of diseases that can impact native and transplanted kidneys. Michigan Medicine Laboratories (MLabs) Renal Pathology Service processes more than 500 cases each year, analyzing needle biopsies from adult and pediatric kidneys and renal allografts.

An extensive panel of tests are typically performed, including:

• Hematoxylin and eosin (H&E) stain
• Periodic Acid-Schiff (PAS)
• Trichrome
• Silver stains for light microscopy
• Immunofluorescence to detect immune deposits
• Electron microscopy to evaluate conditions such as proteinuria (nephritic syndrome), nephritis including rapidly progressive glomerulonephritis, renal failure, vascular disease, and acute and chronic transplant rejection

Successful interpretation of specimens requires carefully correlating clinical history with laboratory data. Therefore, it is important that each renal biopsy received be accompanied by a comprehensive clinical history. Clinicians submitting biopsies are typically contacted with a preliminary diagnosis within 24-48 hours of receipt. A more immediate response is provided when the diagnosis is urgent.