RENAL BIOPSY COMPREHENSIVE EVALUATION (LIGHT MICROSCOPY + IMMUNOFLUORESCENCE)

NB (!): Notify lab prior for guidance. Detailed clinical information is required e.g. 1. Indication (e.g., nephrotic syndrome, nephritic syndrome, AKI, CKD, suspected transplant rejection etc.), relevant lab findings [e.g. serum creatinine, eGFR, urinalysis (protein, RBCs, casts), serum albumin, complement (C3, C4), autoantibodies (ANA, dsDNA, ANCA, anti-GBM), HBV/ HCV/ HIV status etc.]. 2. Transplant status i.e. native (no transplant) vs. transplant kidney. 3. Relevant medications within last 3-6 months. SAMPLE TYPE: Core biopsies PROMPTLY DELIVERED. Two to three separate cores with glomeruli are required for adequate diagnosis. AVOID PLACING ALL CORES IN FORMALIN (samples in formalin will be rejected for immunofluorescence studies). Label specimen adequately (minimum: two patient identifiers, anatomic site). Indicate the TIME/ DATE of biopsy. SPECIMEN PROCESSING & PRESERVATION (SPECIMEN ALLOCATION IS CRITICAL): • Immersed core in 10% NEUTRAL BUFFERED FORMALIN for LIGHT MICROSCOPY (LM). • Immersed core in MICHEL'S TRANSPORT MEDIUM (=ZEUS MEDIUM) for IMMUNOFLUORESCENCE (IF). Note: Formalin fixes tissue but destroys the antigenicity required for IF; therefore, separate samples in separate containers are mandatory. • ELECTRON MICROSCOPY (EM): Not included in this profile. If required, an additional core should be placed in GLUTARALDEHYDE (separate registration and additional charges apply). STORAGE & SHIPPING: • Storage: Specimens should be kept at cool to room temperature. Do NOT freeze as freezing lyses cells and ice crystal formation destroys architecture. Insulated packaging should be considered to avoid excessive heat (extreme ambient temperatures) during transportation. • Shipping temperature: ship at cool to ambient temperature (4-25°C) via overnight courier to ensure deliver within 24 hours of biopsy. STABILITY: Tissue in Michel’s media is stable for 3-5 days (optimal ≤72 hours). Tissue stability is indefinite in formalin.