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 undertaken 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 associated 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.
When publishing with Kerala Medicial Journal (KMJ), authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal. Work includes the material submitted for publication and any other related material submitted to KMJ. In the event that KMJ does not publish said work, the author(s) will be so notified and all rights assigned hereunder will revert to the author(s).
The assignment of rights to KMJ includes but is not expressly limited to rights to edit, publish, reproduce, distribute copies, include in indexes or search databases in print, electronic, or other media, whether or not in use at the time of execution of this agreement.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
The author(s) hereby represents and warrants that they are sole author(s) of the work, that all authors have participated in and agree with the content and conclusions of the work, that the work is original, and does not infringe upon any copyright, propriety, or personal right of any third party, and that no part of it nor any work based on substantially similar data has been submitted to another publication.
