Kidney Scan/biopsy

[Eve]

I saw the renal specialist a week or so ago and they ordered a load of blood tests and said depending on the results they would see about a biopsy. A scan was mentioned but as I'd had one a year ago it was a bit soon to do another one which is all fair enough.

I assumed I'd get the results when I went back in a few months to clinic but got an appointment through this morning for an ultrasound on my UT tract. Nothing to say why save it had been ordered.

I'm guessing the blood and urine results would be back but wondering if, if they wanted a biopsy, whether this would have been said in the letter that one might be done during the ultrasound (if ordered or they think it's needed). Is this likely?

I can try to get through to ask, am thinking they would have said if so but just so I can be prepared. I imagine they are maybe just being thorough but it did make me wonder a bit if something came back on my bloods, well extra to the GFR issues and protein in my urine. Or not maybe nothing extra so they want a look.

Thanks for any advice.

[Sqad]

If they were going to do a renal biopsy, they would tell you,
not nonchalantly drop one in at the time of your scan.

One does not biopsy a kidney lightly and there are quite rigid indications for the procedure.

[Eve]

Thanks Sqad, what I figured but good to know a more medical point of view.

Have been to what I thought was a scan before now only to find they hadn't told me they were removing a lump/taking a biopsy though that was far less "invasive" than I figured a kidney biopsy is (colposcopy).

Got steroid injections in some joints on the same day and an endoscopy the day after so good to be prepared :)

Thanks, as always, for you advice.

[slaney]

I presume the appointment just says Ultrasound (or CT) scan, not Ultrasound guided biopsy?
Is there any patient information leaflet enclosed?
I would ring the appointments desk and ask just to be sure - one would normally require a clotting screen to be done beforehand, but you may have had this done with the last lot of bloods.

[Eve]

Hi Slaney, thanks for that. I gave a ring to see if there was another appointment time that day (going to be a mad 10 bus day between work and appointments that day) and it's just an ultrasound. Not that I'd have minded either way but lots going in that week so good to know for definite.

They did loads of bloods, looks very thorough, looks like the main rule out could be lupus as ANA, complement and DNA done. I had them done a while back and they were ok, can things like that change? I know the rheumatoid factor didn't show up initially. Other stuff is hopefully just a thorough catch all - light chains and electrothings (on my last post). Some other bits too.

[slaney]

Hi Eve - that's good as it sounds as if you have enough going on that day anyway.

Protein electrophoresis is just a way of separating out the various groups of proteins in the serum. A strip looks a bit like this -the pink blobs...

http://pro2services.com/lectures/Winter/Proteins/protelec.gif

..with the lighter faster moving albumin at one end and the heavier antibodies (immunoglobulins) at the other. You have had biochemistry and immunoglobulins done recently so I wouldn't expect too many surprises there.

The light chains are part of the antibody molecule,

http://waynesword.palomar.edu/images/antibod1a.gif

and are excreted in the urine in some rare conditions.

It looks as if the renal team is doing a routine trawl for the common and uncommon causes of kidney problems.

[Eve]

Thanks Slaney, routine is good :)

Immune things were on there too and some stuff I'd never heard of, gamma something I think and other abbreviated stuff - was being nosy at my blood forms on the way to get them done.

They are being very thorough which is great - lovely lovely consultant and registrar too.

They said I have enough going on they know about which could cause issues, interstitial nephritis and globular something (GN something?) were mentioned and as Sqad already said in a previous thread, RA and kidneys is a complex area. I can get things to a certain level but when it goes too sciency I'm lost. I do try and learn about stuff thought to a level I understand and I find it does really help me at medical appointments.

My GGT came back ok I think, said a little bit raised but not much which is good enough for me as my ALT can often hover just above the "normal" rate too. So will see how they go as I think they were waiting to see that before deciding on a liver scan.

I'm gonna be all scanned out! :) Not that I'm complaining though, it's for my benefit.