One in three Australians are at increased risk of kidney disease according to Kidney Health Australia. There are any number of tests that can be used for screening and diagnostic purposes, involving urine and blood samples. Pathologists and  medical scientists analyse the chemical composition of these fluids in order to make a diagnosis that doctors need to help manage any conditions that might be revealed.

Tests might reveal a urinary tract infection or conditions like kidney injury or nephrotic syndrome.

If you or a loved one are diagnosed with a serious kidney disease your health provider will work with pathology to help monitor your kidney function during treatment.

Organ transplant

Late stage kidney disease may require transplant, and with one of the highest success rates for organ transplants in the world, and survival rates exceeding over 90 per cent in the first year, Australia is at the leading edge of medical transplants.

In Australia, the number of people on the waiting list for kidney transplants is usually around 1,500 at any one time, with the wait time usually over three years.

For those individuals requiring kidney transplants, and their loved ones, there are some exciting developments on the horizon.

New developments

 A recent US study based on a trial of 10 organ donors has reported that people receiving kidneys from donors infected with Hepatitis C did not themselves become ill with the virus after taking a course of antiviral medications.

The researchers tested the 10 participants 12 weeks after the drug treatment ended and did not detect Hepatitis C in their blood, although they detected antibodies to the virus in five. But if it was transmitted, transplant infectious disease specialist at Massachusetts General Hospital in Boston, Jay Fishman remains positive, saying “we can manage it”.

In another exciting development, a recent large-scale clinical trial conducted by the National Institutes of Health in the US could allow HIV-positive patients with kidney (or liver) disease to receive transplants from others affected by HIV.

While HIV infected organs are only transferrable to those also living with HIV, the transplant would not only benefit HIV-positive people but also bumps everyone else up on the organ transplant waitlist.

Both studies are great news for those on waiting lists.

Pathology’s role in kidney donation

A test known as ‘tissue typing’ is performed in pathology labs, and today’s techniques mean that DNA testing can be used to obtain the best match possible between donor and recipient. This reduces the risk of a recipient’s immune system rejecting the new organ.

Living kidney donors will also need a range of tests to check they meet health requirements and that donation will be safe for them and for the recipient. As well as the tests to determine if they are a good match, tests to check general health, kidney function and screening for certain illnesses will also be performed. With new developments such as these new studies, pathology is an integral part of monitoring the health of participants, side effects and success.

All transplant recipients need to take medication to reduce the chance of rejection and post-transplant pathology tests will be used to monitor the kidney’s function, assess how the body is responding and pathology will continue to be a part of managing their health into the future.

The post Pathology and kidney disease: from diagnosis to exciting research on transplants first appeared on Know Pathology Know Healthcare.

Pathology tests showed protein in her urine, prompting doctors to urgently perform a kidney biopsy. A kidney biopsy involves taking one or more samples of kidney which are sent to a pathology lab to be analysed under special microscopes. Renal diseases can affect various components of the kidney and therefore samples need to be stained with multiple stains to assess various components of kidney tissue. Kidney biopsies are highly technical and very labour intensive, requiring a high level of expertise to obtain a rare diagnosis.

The anatomical pathologist diagnosed Linda with a rare form of nephrotic syndrome. She was told her options were transplant, dialysis or death.

“When doctors told me the news, it was a very hard pill to swallow but I knew I had to accept it. My inner-strength helped me to keep going”, said the mother of two.

Nephrotic Syndrome (NS) is a collection of symptoms that indicate kidney damage. It is characterised by excess proteins in the urine, exceptionally low levels of albumin in the blood and swelling caused by fluid trapped in the body’s tissues.

Despite the doctor’s prognosis, Linda managed to continue living normally for seven years. During that period, her kidney function decreased steadily until eventually doctors needed to intervene – it was time to begin the search for an organ donor.

Little did Linda know but her mother was preparing herself to become an organ donor.  At 62, Sylvana Crkovski knew she would need to be in good health for the operation so she revamped her diet and fitness regime and succeeded in losing 10kg. Linda’s nephrologist noticed the change and agreed to test if she was a match.

Compatibility testing for organ donors begins with a blood test to examine their blood type and determine if it will match the recipient’s blood. If their blood type is compatible with the recipient, they’ll receive further blood tests such as tissue typing and cross-matching to see if the recipient will react to their kidney. If there is no reaction, the transplant surgery can take place.

Sylvana underwent six months of health assessments, involving DNA and blood tests. Finally, pathology results gave Linda’s family the news they were hoping for: Sylvana was a perfect match.

On the day of their surgery at Royal Melbourne Hospital, Linda and her mother held each other’s hands as they were wheeled into the operating theatre. Linda will never forget the words her mother said to the surgeon just before the operation: “If the first kidney doesn’t work, take the other kidney”. Sylvana was willing to sacrifice both kidneys and endure dialysis if it meant saving her daughter’s life. The procedures went well and mother and daughter were released after five days.

Linda will need to take medication and undergo regular testing for the rest of her life but since the operation, she has vowed to live life to the fullest.

This July Linda competed in the Transplant World Games in Spain, where she won a gold medal in paddle tennis. When she’s not smashing it on the tennis court, Linda’s busy volunteering as a Fit for Life ambassador which sees her visiting patients in dialysis wards.

With the arrival of  Donate Life Week on the 31^st July, Linda wants to encourage more people to donate their organs. “I urge every Australian to make their donation decision count by heading to donatelife.gov.au and registering their donation decision.”

The post Mother’s kidney is the winning match for tennis champion, Linda first appeared on Know Pathology Know Healthcare.