Renal biopsy improves renal functional prognosis of CKD

A recent study by Tianyi Zhang and peers suggest that renal biopsy improves the renal functional prognosis of chronic kidney disease (CKD) patients with impaired renal function. Also, the result implies that 24-hour urine protein excretion more than 1 g/d is a predictor of poor renal outcomes in CKD patients who did not receive renal biopsy. The findings of the study were published in BMC Nephrology.

This study aimed to investigate whether renal biopsy improves the renal functional prognosis of CKD patients with impaired renal function. The study retrospectively enrolled 300 CKD patients, 150 of whom received percutaneous renal biopsy while the others did not.

The results showed that patients who received renal biopsy had a significantly higher renal survival probability than those who did not (P < 0.001).

The eGFR of the biopsy group increased from 52.2 ± 14.4 to 67.4 ± 37.8 ml/min/1.73 m² during the follow-up period, whereas it decreased from 55.3 ± 17.1 to 29.8 ± 19.1 ml/min/1.73 m² in the non-biopsy group.

Moreover, Cox regression analysis revealed that 24-hour urine protein excretion (24 h UPE) more than 1 g/d was an independent predictor for poor renal outcomes in the non-biopsy group but not in the renal biopsy group (HR = 1.719, P = 0.040).

The study has implications for clinical practice as it suggests that renal biopsy may be necessary for CKD patients with impaired renal function to make pathological diagnoses and guide clinical management. However, the study has some limitations, such as its retrospective design and the possibility of selection bias. Future prospective studies with larger sample sizes and longer follow-up periods are needed to confirm these findings.

Source:

Zhang, T., Yang, X., Zhang, M., Zhou, W., Jin, Y., Zhou, H., Zhou, Y., Wang, Q., & Mou, S. (2023). Effects of receiving renal biopsy on the prognosis of chronic kidney disease patients with impaired renal function. In BMC Nephrology (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12882-023-03097-2