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Richard J. Glassock, Con: Kidney biopsy: an irreplaceable tool for patient management in nephrology, Nephrology Dialysis Transplantation, Volume 30, Issue 4, April 2015, Pages 528–531, https://doi.org/10.1093/ndt/gfv044
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It is ironic that this defense of renal biopsy as a vital clinical tool in the management of kidney disease is being written so soon after the death of Claus Brun (at age 100 years) [1]. Professor Brun is rightly credited (along with his close associate in Copenhagen, Professor Poul Iverson) with the introduction of percutaneous biopsy of the kidney into clinical medicine in 1951, more than six decades ago [2]. Early adopters of the technique, especially Robert Kark, Robert Muehrcke and Conrad Pirani in the USA [3], made major contributions to establishing its clinical value. While the technique of kidney biopsy has evolved (position used, localization method, needles employed, performance site, training of proceduralists) over the intervening years, its value in diagnosis, prognosis and therapeutic decision-making has increased enormously [4, 5]. This evolution has been aided especially by the appearance of new methods of analyzing the tissue obtained (such as immunofluorescence [6] and electron microscopy [7])—a process which continues even in the present time, as exemplified by such techniques as laser-capture mass spectrometry [8] and transcriptomic analysis [9] of renal tissue. Advances in treatment modalities for many renal diseases have only heightened the value of kidney biopsy, especially in the field of glomerular diseases. The discipline of renal pathology, originally dependent on the autopsy, has now blossomed into a vibrant branch of knowledge, with its own set of standards and many artful practitioners [4, 5, 10]. Who knows how many renal biopsies have been performed throughout the world since the epoch-making year of 1951—perhaps millions!
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