Kidney Workup

Kidney biopsy samples obtained for mass/tumor/cyst diagnosis will be collected and sent locally to Pathology Associates for processing. 
Samples obtained for medical diseases will be processed at CRMC Lab and sent to University of California at Los Angeles (UCLA) for testing per the Kidney Biopsy Processing for UCLA procedure.  This procedure addresses the kidney biopsies for medical disease.

KIDWU

Kidney Biopsy

KWCHG =Kidney Workup Charges

• KWSP: Kidney Surgical Pathology:  88305x1
• KWSS1/2/3:  Special Stain 1,2 and 3:  88313x3
• KWA 01/02/03/04/05/06/07/08/09:  Kidney Antibody  88346x9
• KWEM:  Kidney Electon Microscopy:  88348x1

Kidney Biopsy Collection:Each core of tissue is gently removed from the needle with a smaller needle (avoid crushing with a forceps) and placed into the fixative solutions.  It is very important to keep the specimen from drying out. Avoid placing tissue on gauze or other porous surface to which it may stick.
 
At least one needle core is taken in this manner for each of the various methodologies.  Use of a magnifying lens is helpful to determine if glomeruli are present in the core samples.  Please see linked references below for images.  
 
If there is concern about obtaining adequate material to allocate at least one full core in each fixative (preferably more than one for the formalin used for LM), a smaller number of cores may be divided with a sharp clean scalpel in the following manner to allocate some tissue (hopefully with some glomeruli) into each of the fixative vials. The color difference between cortical surface and medulla establishes orientation, in the absence of some means of magnifying the tissue cores:  
                                              
             
 

Kidney (renal) biopsy samples for medical diseases (see above) that are collected within the Community Medical Center (CMC) system will be centralized and sent to UCLA from the Community Regional Medical Center (CRMC) Send Outs Department.  Samples are submitted in the vials contained in collection kits provided by UCLA.  Samples must meet the labeling requirements defined in the Patient Identification policy.  Test is orderable in the hospital information system, EPIC (KIDWU or Lab-Kidney Workup).  Sample must be submitted with a completed UCLA requisition that documents the patient diagnosis and details about the source of the specimen.

The vials in the collection kits contain chemicals which are considered hazardous.  Appropriate personal protective equipment (PPE) must be worn when placing specimens in the vials as well as when preparing the samples for shipping.  Samples will be shipped in accordance with the Packaging and Shipping Laboratory Specimens procedure.

Sample is delivered to Lab in a labeled biohazard transport bag to help identify that it is a kidney biopsy.  Instructional label on bag states "Deliver to CRMC Lab (Send-Outs Dept)".  If Send Outs Department is not staffed, Specimen Processing will perform the General Receipt.

1. Don the appropriate PPE before handling sample.
2. Review sample for acceptable specimen labeling.  Samples not labeled appropriately will be handled per the Laboratory Specimen Acceptance/Rejection Policy.
3. Order test in Soft if needed.  Ensure that the ordering physician entered is the nephrologist, the physician that is listed as the ordering physician on the Pathology Requisition.  Include the performing physician, the radiologist, in the ordering comments.
4. If sample has been collected and received at Clovis Lab, send the specimen to CRMC Lab via the courier system.
5. Place sample and paperwork in Send Outs refrigerator until it is time to prepare for transport.

1. Renal Biopsy Collection Kit - Supplied by UCLA.  Obtained from CRMC Send-Out/Reference Laboratory Department.
   1. EM Fixative
   2. Zeus Fixative
   3. 10% Buffered Formalin.  
   4. 

 

2. UCLA Pathology Test Requisition

 

3. Biohazard Transport Bag labeled with delivery instructions.
   1.  

 

4. FedEx packaging materials

 

5. POLYFORM-F Formaldehyde Spill Control Agent; Sasco

The entire specimen is sent by overnight transport to UCLA, Department of Pathology, for processing, evaluation and interpretation.  To ensure specimen integrity, samples can only be shipped Monday through Thursday.  Friday obtained biopsies cannot be processed at UCLA until Tuesday.  Shipping schedule is also adjusted during weeks in which there is a holiday.

 Kidney biopsy samples obtained for medical diseases (excludes those done for mass/tumor/cyst) will be processed and sent to University of California at Los Angeles (UCLA) for testing.  This procedure describes the steps necessary to process the sample in a safe fashion and prepare it for transport to the testing location.