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Renal Biopsy Research in the Former Soviet Union: Prevention of a Negligent Custom

DOI: 10.5402/2013/980859

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Abstract:

Insufficient international coordination of medical research and partial isolation from the international scientific community can result in repetition of research already performed in other countries. Renal biopsy was broadly used for research in the former Soviet Union. It was performed, sometimes without sufficient clinical indications, in patients with amyloidosis, renovascular hypertension (from both kidneys: on the side of the renal artery stenosis and the contralateral one), chronic alcoholism, and acute and chronic pyelonephritis (intraoperative wedge and core biopsies). In chronic alcoholism, biopsies were taken from kidneys, pancreas, salivary glands, stomach, lung, skin, and liver, sometimes repeatedly. The classification of glomerulonephritis was different from those used internationally, for example, it did not include IgA nephropathy as a separate entity. Several examples of studies based on renal biopsies are discussed in this paper. A conclusion is however optimistic: the upturn in economy enables today to modernize equipment and introduce new methods, while broadening international cooperation facilitates the flow of foreign experience into the country. The purpose of this paper was to prevent inadequate use of renal biopsy in future. Insufficient international coordination of medical research and partial isolation from the scientific community can result in unnecessary experiments and clinical studies with repetition of research already performed in other countries; while contraindications, known from the literature, are sometimes disregarded. Renal biopsy (RB) was broadly used for research in some institutions of the former Soviet Union (SU), for example, an overview encompassing the years 1970–1999 analyzed 4400 core biopsies from kidneys taken at the Moscow Medical Academy [1]. Even if RB is performed according to the indications, a part of the specimen is sometimes consumed for purely scientific purposes, which can be justified if research is bona fide. Electron microscopy was rarely used for the diagnostic purposes; nevertheless, 1/3 of the renal tissue cylinder was taken for resin embedding. Semithin (around 4?μm) epoxy resin sections, often providing significant information, were made in many cases for scientific purposes but were usually not used for diagnostics, the latter being performed mainly on the basis of paraffin sections and immunofluorescence. The number of RB performed yearly has decreased since the 1980s; however, today there are more funds for research, and it might be useful to recollect some experience from the

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