Kidney Biopsy

This form captures information about any renal pathology reports conducted for the patient.

This form is repeatable, and a new form should be created for each kidney biopsy that the patient had.

This form has four (4) pages, as follows:

• Biopsy Summary

• Light Microscopy Findings

• Immunofluorescence Findings

• Electron Microscopy Findings  

The Biopsy Summary page captures general information about the kidney biopsy: Date of biopsy, whether the biopsy was performed on native or transplant tissue, whether this is the biopsy that established the INDEX clinicopathological diagnosis, how many glomeruli were seen, and how many glomeruli were globally or segmentally obsolescent, and percent tubular atrophy and interstitial fibrosis.

The Light Microscopy Findings page captures information about the light microscopy portion of the biopsy. The first question asked is whether or not the light microscopy section of the biopsy was performed. If not, please specify the reason in the comments section. Select findings from the options presented on this form if they are present, andpresent and specify where needed.

The Immunofluorescence Findings page captures information about the immunofluorescence portion of the biopsy. The first question asked is whether or not the immunofluorescence section of the biopsy was performed. If not, please specify the reason in the comments section. In the first section, “Standard Immunofluorescence Findings,” please add a row for every positive stain that was seen.

If a stain was positive in multiple locations, add a new row for each location of each positive stain. For example, add two rows if IgA was positive in both the mesangium and TBMs. In the second section, select any positive special staining. If other, please select “Other” and specify.

The Electron Microscopy Findings page captures information about the electron microscopy portion of the biopsy. The first question asked is whether or not the electron microscopy section of the biopsy was performed. If not, please specify the reason in the comments section. Select findings from the options presented on this form if they are present, and specify where needed.

Please note that this form is repeatable for as many renal biopsies as a patient may have had. To add a new form, click on the index diagnosis icon, then add another Kidney Biopsy under Log Forms.

• If the date of the kidney biopsy is unavailable, use July 1 with the approximate year of diagnosis. If an exact year is not available, an approximation is acceptable. If any approximations are used, please make a note in the comments section.

• Once the date is entered, please click on the calculator to calculate the age at the time of the INDEX diagnosis date.