REnal pathology

Comprehensive results

All results include the following information-based standards for diagnostic evaluation and reporting of non-neoplastic renal disease:

• Clinical history.
• Gross description of biopsy specimen.
• Light microscopy results.
• Immunofluorescence microscopy results.
• Electron microscopy results.
• Diagnostic comments.
• Additional stains, performed on a case-by-case basis.

The Mayo Clinic difference

Our highly trained laboratory techs have expertise in assessing and potentially reallocating LM and EM fixed tissues, which ensures adequacy of the material required for consultation. Additionally, when samples are submitted with limited or no tissue in the immunofluorescence preservative (Michel’s/Zeus), we can perform IF using a paraffin-based salvage technique. Combined, these techniques help facilitate diagnosis even in cases where a limited biopsy specimen is received.

We provide high-contrast images by using superior quality processing methods to generate samples for EM. This enables detection of abnormalities, such as amyloid fibrils, tubuloreticular inclusions, and subtle substructure in deposits that may not be visible in lower contrast images produced using rapid throughput methodologies.

Each member of our EM team completes a rigorous training process and recertification at specified intervals. This includes training to apply the same methodical approach for examining the four major tissue compartments — glomeruli, tubules, interstitium, and vessels — with increasing magnification. This provides clarity on the kidney structures and the location of abnormalities, such as deposits, providing pathologists a complete picture to secure the diagnosis.

Rapid turnaround times

• Initial reports of LM and IF findings in most cases are available the day after specimen receipt.
• EM results are provided as supplemental reports within one to two days of initial reporting.
• With advanced notice, expedited processing is available for clinically urgent situations (e.g., rapidly progressive glomerulonephritis or acute kidney injury). In such instances, preliminary LM and IF results are available and called to the nephrologist on the day of sample receipt.
• Weekend case readout when specimens arrive on Friday.
• Some additional studies may add one to two days to TAT. Results from mass spectrometry, as an addendum, are available in approximately one week.

Beyond the test result

The anatomic pathology laboratories’ ten-member team of renal pathologists collaborates with Mayo Clinic’s Division of Nephrology and Hypertension and holds special interests in non-neoplastic kidney disease. Our pathologists are available to offer support and strive for superior client communication.

• Mayo Clinic renal pathologists routinely call the ordering provider directly to report and discuss the kidney biopsy findings.
• Renal biopsy personnel are on call 24 hours a day, 7 days a week, 365 days a year to answer client calls, respond to questions, and process requests for expedited service. To inquire about the status of a biopsy or request rush processing during normal weekday business hours, clients can call Mayo Clinic’s pathology reporting specialists directly at 507-284-5677 or, if after hours or on the weekend, clients can call 1-855-516-8404.
• Client referral teams can set up automated emails for renal pathology reports. These secure emails include a link to the pathology report and to the kidney biopsy images. These can be sent to the ordering nephrologist to augment result delivery. For help with user setup and notifications, clients should contact their Regional Service Representative or Customer Service. Nephrologists should reach out to their referring hospital’s send-out area.