Past and Present of Renal Biopsy in the Management of Patients with Glomerular Diseases

Chronic kidney disease (CKD) is amajor health problem affecting 10–16% of the general adult population in Asia, Europe, Australia, and the United States^{(1,2,3,4,5,6)}. Progression to end stage renal disease (ESRD) remains a major clinical problem because the number and the cost: there are currently over a million patients worldwide on dialysis, with the number continuing to increase by ~7% annually⁽⁷⁾ and the cost of dialysis is very expensive, costing ~US$80,000 per patient per year in the United States⁽⁸⁾.

Since 1951 when was the first published report of the use of kidney biopsy in the diagnosis of medical kidney disease⁽⁹⁾, renal biopsy is an essential procedure in the diagnosis of renal disease, and it is now hard to imagine that one could practice nephrology without knowing pathology. However, there remain no consensus guidelines available to the global renal community outlining the indications for this important diagnostic and prognostic test. In this review, we shall outline the current and potential future uses of renal biopsy in diagnosis, prognosis, response to treatment, and disease progression in the setting of current day nephrology.