Friday, February 20, 2009

History of Renal Biopsy

Who was the first doctor to have the idea (and the audacity) to stick a needle into the kidney in order to obtain a tissue diagnosis of kidney disease?  The "inventors of the renal biopsy" have been identified historically as Poul Iversen and Claus Brun (from Copenhagen, Denmark), and their classic paper, "Aspiration Biopsy of the Kidney" from 1951, can be found here.  While the are reports of other physicians performing renal biopsies elsewhere before this, the 1951 Iverson/Brun paper was the first organized, published approach. 

Briefly, the authors describe placing the patient in a sitting position, and localizing the kidney via iv pyelogrophy.  Then, after insertion of the needle to the marked length, vacuum suction was applied to the syringe in order to aspirate back a core of renal tissue approximately 1-2 cm in length.  Using this method, the authors describe obtaining adequate biopsy tissue in 42 out of 66 patients with a minimum of bleeding complications.  In this paper they also describe the ability to make diagnoses of amyloidosis, diabetic nephropathy, hypercalcemia, and chronic glomerulonephritis based on the resulting pathology.  

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