Biopsy Vs New Biopsy in Adult Nephrotics - An Eternal Controversy

Abstract

In children, since 80% cases of nephrotic syndrome are minimal change Glomerulonephritis and respond to steroids, treatment with a course of Prednisolone in given after preliminary investigations. Further investigations including kidney biopsy are under-taken only if the child is 'steroid resistant', 'steroid dependent or a frequent relapser in whom more powerful immuno suppressive treatment is contemplated. The situation in adults is different since a wide range of primary or secondary glomerular diseases present with nephrotic syndrome. Identification of the cause helps in choosing the appropriate specific treatment from early stages.
There was a time when people believed that careful 'urine examination' as equivalent to a non invasive kidney biopsy. Although the value of careful urine examination is not questioned, it cannot replace renal biopsy which has become safer and is not associ-ated with pain or morbidity. The ultrasound guidance and use of biopsy 'guns' have made the procedure less traumatic and safe. Most centers perform renal biopsy as an outpatient procedure.