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Kidney Biopsy Purpose CKD — ESENeph MCQ

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EasyChronic Kidney DiseaseKidney Biopsy Purpose CKDESENeph

A 48-year-old woman with CKD G3b has a new finding of proteinuria (uPCR 150 mg/mmol). She has no diabetes or hypertension. ANA and ANCA are negative. Complement is normal. Serum electrophoresis shows no paraprotein. Her eGFR has been stable. Kidney biopsy is being considered. According to KDIGO 2024, what is the purpose of kidney biopsy in CKD?

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Correct answer: A — Kidney biopsy determines the cause of CKD which may change management; it is recommended when clinically appropriate and when the cause is uncertain

KDIGO 2024 recommends kidney biopsy as an acceptable, safe diagnostic test to evaluate the cause of CKD and guide treatment decisions when clinically appropriate (1D). New unexplained proteinuria in a patient without obvious cause (no diabetes, no hypertension, no systemic disease) is an indication for biopsy. The histological diagnosis may reveal a treatable condition (e.g. membranous nephropathy, IgA nephropathy, FSGS) that would alter management. Even when eGFR is stable, proteinuria may indicate an active disease process requiring intervention.

Reference: KDIGO 2024 – CKD Guideline