Immunoperoxidase for the demonstration of immune deposits in renal biopsies

Abstract Renal biopsy is essential for the accurate diagnosis and management of a variety of kidney disorders associated with proteinuria, haematuria and grades of renal failure. The histopathology laboratory should take complete responsibility for the biopsy as soon as it has been taken; an experienced member of the technical staff should assess the biopsy for adequacy, take a sample for electron microscopy and then prepare the tissue for light microscopy and immunochemistry. Traditionally, immunofluorescence has been used to demonstrate immune deposits; however, immunoperoxidase methods can be used as long as strict adherence to protocols by experienced technical staff is observed with rigorous quality control. Advantages of successful immunoperoxidase techniques include the need for only one renal core, permanence of the section and good morphological correlation; disadvantages are centred on the difficulty of the technique, and the poor detection of linear IgG in cases of Goodpasture's disease.