Possibilities of intraoperative laparoscopic nephrobiopsy for diagnostics of latent kidney diseases.

Abstract

Introduction. Chronic kidney disease (CKD) is a worldwide problem with an increasing general and widespread incidence affecting people of all age groups and races. All stages of CKD are at risk of some somatic diseases, reduced quality of life and mortality. Material and methods. The study included 30 patients (16 men and 14 women) who underwent surgical treatment with intraoperative kidney biopsy to identify possible morphological predictors of CKD development in the Urology Department of the Krasnoyarsk Regional Clinical Hospital. Operations were performed laparoscopically for kidney cysts, stenosis of the pyelo-ureteral segment, and kidney neoplasms. All patients from the anamnesis data did not have glomerular lesions. The age of the patients ranged from 21 to 79 years. Directly obtained kidney tissues were performed using puncture processing of a 16G guillotine needle intraoperatively under visual control. Tissue columns were obtained, separated for light-optical microscopy, immunofluorescence reaction, and electron microscopy. Posting samples for morphological studies was carried out according to the standard method. Results. Based on the results of 30 nephrobiopsies obtained during laparoscopic operations on the kidney, latent glomerular lesions were diagnosed for the first time in 6.7% and moderate or severe manifestations of tubulo-interstitial nephritis in 33.3%. In addition, mesangial proliferation and tubular atrophy are reduced in 63.3% of biopsy specimens. Conclusion. Intraoperative work-controlled nephrobiopsy is a safe method for assessing the morphofunctional state of the renal parenchyma, which allows one-time treatment of urological load and the identification of latent phenomena to identify preclinical manifestations.