Native Renal Biopsy – Histology and Direct Immunofluorescence (DIFL)

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Testing Laboratory

Auckland Te Toka Tumai | Auckland Hospital

Department

Histology

Delphic Registration Code (Alpha Code)

ASRG

Test Code (Numeric Code)

9030

Laboratory Handling

Sample Stability

Michel's Transport Medium (MTM) specimen (for DIFL) stable 24-48 hrs at ambient temperature; Formalin-fixed tissue stable at room temperature.

Synonyms

Native Kidney Biopsy

Turnaround Time

15 days

Our reporting timelines are aligned with the RCPA's benchmark for Anatomical Pathology. We aim to provide final Pathologist reports according to the following performance targets: 80% of cases reported within 5 working days, 90% of cases reported within 10 working days. 98% of cases reported within 15 working days. Notes: These timelines apply to routine cases. Complex cases requiring additional investigation may require extended processing times.

Specimen Type

  • Tissue

Specimen Requirements

Tube/Container Type:

Preferred
  • NUNC Tube
  • Specimen Container

Paediatric Specimen Requirements

Tube/Container Type:

Preferred
  • NUNC Tube
  • Specimen Container

Pre-testing Requirements

Consultation with a Renal Pathologist is mandatory before the biopsy can be processed urgently.

The following Renal Pathologist handle Renal Native, Renal Transplant, and Renal Hybrid biopsies:
• Dr Nicky Kingston
• Dr Christy Punnoose
• Dr Mary John
• Dr Mike Watson

A completed Renal Request form must accompany the specimen. The name of the requesting clinician and a contact number for reporting results must be clearly written on the request form.

Histology laboratory must be notified that the specimen is on its way to the laboratory on +64 (0)9 307 8995, ext. 22090.

If the procedure is expected to be delayed, or is planned outside Histology Laboratory working hours, the following must occur:

• Notify the on‑call Renal Pathologist via the Hospital Switchboard on +64 (0)9 307 4949.
• Notify the Scientist on call on +64 (0)21 522 298.

Additional Specimen Information

Collection Instructions:

Obtain sufficient renal cortex using a 16–18gauge needle, typically aiming for two to three cores placed into the appropriate transport media.
Each core should be at least 1 cm in length, with the goal of capturing:
• 10–20 glomeruli for routine histology
• At least one or more glomeruli for Direct Immunofluorescence (DIFL)

Adequate cortical sampling is essential to ensure accurate morphological and immunopathological assessment.

Specimen Requirements

Renal Native Biopsy requires two separate tissue samples, each submitted in its own specimen container:
1. Sample for Routine Histology
• Place 1 - 2 x tissue core in 10% Neutral Buffered Formalin
• Used for paraffin embedding and morphological assessment

2. Sample for Direct Immunofluorescence (DIFL)
• Place 1x tissue core immediately into Michel’s Transport Medium (MTM).
• Used to assess immune complex deposition (IgG, IgA, IgM, C3, C1q, Kappa, and Lambda light chains).

These two specimens provide complementary diagnostic information and are both essential for a definitive renal diagnosis.

Note: Electron Microscopy (EM) sampling will be performed from the tissue submitted in 10% Neutral Buffered Formalin.

Operating theatres do not handle glutaraldehyde fixative therefore sampling for EM will be carried out within the Histology laboratory.

Last updated: 01/04/2026