Table 1.
Biopsy characteristics including date, indication, brief clinical history, and final diagnosis
Case | Biopsy Type | Biopsy Date | Biopsy Indication | Clinical History | Biopsy Diagnosis |
1 | N | April 2020 | Proteinuria (10 g), increased Cr (1.7) | 33 yr F with DM2, CHF | Diffuse and nodular glomerulosclerosis, consistent with diabetic nephropathy, class 3 |
2 | N | April 2020 | AKI (Cr 2.7), low C4 | 75 yr M with HTN, hyperlipidemia, CVA, lung cavitary lesions | Mesangiopathic immune complex disease, most consistent with resolving-phase infectious glomerulonephritis |
3 | N | April 2020 | AKI (Cr 8.4) | 46 yr M with hematuria, hemoptysis, and weakness | Diffuse crescentic and necrotizing GN, pauci-immune (ANCA-associated) type |
4 | N | April 2020 | AKI (Cr 1.5) | 33 yr M with h/o methamphetamine abuse | Thrombotic microangiopathy |
5 | N | March 2020 | Rapid decline of renal function | 72 yr M with DM2, HTN on hydralazine. Positive ANA (1:640) and ANCA | Mesangiopathic immune complex disease, suspicious for autoimmune diseases such as lupus or lupus-like conditions |
6 | N | March 2020 | History of IgAN, now nephrotic-range proteinuria | 40 yr, Cr 1.3;UA: 3+ blood, 3+ protein | IgAN with focal cellular crescents and fibrinoid necrosis |
7 | T | March 2020 | AKI (Cr 7.9) | 47 yr M with ESKD from DM/HTN | Acute cellular rejection, Banff IB |
Acute vascular rejection, Banff IIB | |||||
C4d negative | |||||
SV-40 negative | |||||
8 | T | March 2020 | AKI (Cr 2.7) | 55 yr M with ESKD from RCC requiring bilateral nephrectomies | Borderline changes by Banff criteria (suspicious for acute cellular rejection) |
C4d negative | |||||
SV-40 negative | |||||
9 | T | March 2020 | AKI (Cr 4.3), anemia, leukopenia | 28 yr M with ESKD of unknown etiology | Acute cellular rejection, Banff IB |
Acute vascular rejection, Banff IIB | |||||
C4d negative | |||||
SV-40 negative | |||||
10 | T | February 2020 | AKI (Cr 5.1) | 36 yr F with h/o ESKD due to SLE. Admitted with pulmonary HTN, acute decompensated HFpEF, and AKI. DSAs negative | Negative for rejection |
Findings favor thrombotic microangiopathy | |||||
C4d negative | |||||
SV-40 negative | |||||
11 | T | October 2019 | AKI (Cr 6.5) | 49 yr M with ESKD from DM/HTN s/p DDKT with DGF | Negative for rejection |
C4d negative | |||||
SV-40 negative | |||||
12 | T | October 2019 | AKI (Cr 1.7) | 53 yr with ESKD from DM2 | Borderline changes by Banff criteria |
C4d negative | |||||
SV-40 negative | |||||
13 | T | October 2019 | AKI (Cr 4.6) | 38 yr M with HTN, AFib, HLPD, s/p kidney transplant with diarrhea | Acute cellular rejection, Banff IA |
C4d positive | |||||
SV-40 negative | |||||
14 | T | October 2019 | Pain over allograft, AKI (Cr 1.8) | 40 yr M with ESKD from HTN/DM | BK polyomavirus nephropathy |
Negative for rejection | |||||
C4d negative | |||||
SV-40 positive | |||||
15 | T | October 2019 | AKI (Cr 2.7) | 67 yr F with ESKD from DM/HTN | Borderline changes by Banff criteria |
C4d negative | |||||
SV-40 negative |
N, native kidney; Cr, creatinine (all values are in mg/dl; reference range, 0.6–1.3 mg/dl); F, female; DM2, type 2 diabetes mellitus; CHF, congestive heart failure; M, male; HTN, hypertension; CVA, cerebrovascular accident; h/o, history of; ANA, anti-nuclear antibodies; IgAN, IgA nephropathy; UA, urinalysis; T, transplant kidney; SV-40, simian virus 40; RCC, renal cell carcinoma; HFpEF, heart failure with preserved ejection fraction; DSA, donor-specific antibody; s/p, status post; DDKT, deceased donor kidney transplant; DGF, delayed graft function; AFib, atrial fibrillation; HLPD, hyperlipidemia.