Director:  Vijay Vanguri, MD

 

About Us 

Renal pathology, or nephropathology, is the subspecialty of surgical pathology which is focused on the diagnosis and characterization of medical diseases of the kidney.  The interpretation of renal biopsies is complex and challenging, and it utilizes multiple microscopic modalities to accurately describe the patterns of injury evident in the biopsy.  These patterns of injury must be considered along with a comprehensive assessment of the available clinical information in each patient's case in order to arrive at the likely mechanisms of disease.  In this way, Dr. Vanguri considers each patient individually and is closely involved in patient care along with nephrologists from the Division of Renal Medicine.

 

Medical kidney biopsies are most commonly performed for assessment of renal failure or blood or protein in the urine, for either native kidneys or kidney transplants.  The procedure is performed with ultrasound or CT assistance by a nephrologist or radiologist, and each needle core is evaluated at the bedside by a pathologist using a stereomicroscope in an attempt to assess adequacy of tissue.  Because tissue is needed for three different microscopic studies (light microscopy, immunofluorescence microscopy, and electron microscopy), multiple passes with the biopsy needle are usually necessary for the most accurate diagnosis.  Dr. Vanguri notifies the nephrologist directly with a preliminary interpretation based on light microscopy most often within 24 hours of the biopsy, and is in contact with the nephrologists as the results of immunofluorescence and electron microscopy become available.  Biopsies are frequently discussed in detail during a weekly conference and with the aid of multiheaded microscopes.

 

The renal pathology service at UMass Memorial Pathology processes approximately 160 biopsies annually from both native and transplant kidneys in adults and children.  Dr. Vanguri, a board-certified anatomic pathologist and subspecialty fellowship-trained renal pathologist, joined the Department of Pathology in January of 2009 after completion of his residency and fellowship training at Brigham and Women’s Hospital in Boston, Massachusetts in June of 2007 and completion of a post-doctoral research fellowship at Harvard Medical School.