scholarly journals Standardized reporting of monoclonal immunoglobulin–associated renal diseases: recommendations from a Mayo Clinic/Renal Pathology Society Working Group

2020 ◽  
Vol 98 (2) ◽  
pp. 310-313
Author(s):  
Sanjeev Sethi ◽  
Cynthia C. Nast ◽  
Vivette D. D’Agati ◽  
Fernando C. Fervenza ◽  
Richard J. Glassock ◽  
...  
Keyword(s):  
Mayo Clinic ◽  
Working Group ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Monoclonal Immunoglobulin ◽  
Standardized Reporting

scholarly journals More than ancillary records: clinical implications of renal pathology examination in tumor nephrectomy specimens

2021 ◽  
Author(s):  
Johannes Philipp Kläger ◽  
Ahmad Al-Taleb ◽  
Mladen Pavlovic ◽  
Andrea Haitel ◽  
Eva Comperat ◽  
...  
Keyword(s):  
Interstitial Fibrosis ◽  
Renal Pathology ◽  
Vascular Lesions ◽  
Renal Tumors ◽  
Renal Diseases ◽  
Tumor Type ◽  
Neoplastic Tissue ◽  
Cell Renal Cell Carcinoma ◽  
Hypertensive Nephropathy ◽  
Tumor Nephrectomy

Abstract Background Nephrectomy is the management of choice for the treatment of renal tumors. Surgical pathologists primarily focus on tumor diagnosis and investigations relating to prognosis or therapy. Pathological changes in non-neoplastic tissue may, however, be relevant for further management and should be thoroughly assessed. Methods Here, we examined the non-neoplastic renal parenchyma in 206 tumor nephrectomy specimens for the presence of glomerular, tubulo-interstitial, or vascular lesions, and correlated them with clinical parameters and outcome of renal function. Results We analyzed 188 malignant and 18 benign or pseudo-tumorous lesions. The most common tumor type was clear cell renal cell carcinoma (CCRCC, n = 106) followed by papillary or urothelial carcinomas (n = 25). Renal pathology examination revealed the presence of kidney disease in 39 cases (18.9%). Glomerulonephritis was found in 15 cases (7.3%), and the most frequent was IgA nephropathy (n = 6; 2.9%). Vasculitis was found in two cases (0.9%). In 15 cases we found tubulo-interstitial nephritis, and in 9 severe diabetic or hypertensive nephropathy. Partial nephrectomy was not linked to better eGFR at follow-up. Age, vascular nephropathy, glomerular scarring and interstitial fibrosis were the leading independent negative factors influencing eGFR at time of surgery, whereas proteinuria was associated with reduced eGFR at 1 year. Conclusion Our large study population indicates a high incidence of renal diseases potentially relevant for the postoperative management of patients with renal neoplasia. Consistent and systematic reporting of non-neoplastic renal pathology in tumor nephrectomy specimens should therefore be mandatory.

Animal models of monoclonal immunoglobulin-related renal diseases

2018 ◽  
Vol 14 (4) ◽  
pp. 246-264 ◽  
Author(s):  
Christophe Sirac ◽  
Guillermo A. Herrera ◽  
Paul W. Sanders ◽  
Vecihi Batuman ◽  
Sebastien Bender ◽  
...  
Keyword(s):  
Animal Models ◽  
Renal Diseases ◽  
Monoclonal Immunoglobulin

Renal pathology

2017 ◽  
Author(s):  
James Carton
Keyword(s):  
Kidney Disease ◽  
Basement Membrane ◽  
Reflux Nephropathy ◽  
Kidney Injury ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Obstructive Nephropathy ◽  
Hypertensive Nephropathy ◽  
Membranous Glomerulopathy ◽  
Post Infectious

This chapter discusses renal pathology, including acute kidney injury (AKI), chronic kidney disease (CKD), nephrotic syndrome, hereditary renal diseases, Alport’s syndrome and thin basement membrane lesion, hypertensive nephropathy, diabetic nephropathy, minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous glomerulopathy, glomerulonephritis, IgA nephropathy, post-infectious glomerulonephritis, C3 glomerulopathy, anti-glomerular basement membrane disease, monoclonal gammopathy-associated kidney disease, acute tubular injury, acute tubulointerstitial nephritis, reflux nephropathy, and obstructive nephropathy.

scholarly journals P0114BENEFITS AND CHALLENGES OF A RENAL BIOPSY REGISTRY AND NETWORK - FCGG EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Wim Laurens ◽  
Johan De Meester ◽  
Ben Sprangers ◽  
Steven Van Laecke ◽  
Dendooven Amélie ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Clinical Care ◽  
Adult Population ◽  
Age Groups ◽  
Time Frame ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Renal Biopsies

Abstract Background and Aims End December 2016, a renal biopsy network in the Flemish region (Belgium) was founded as a collaboration between the renal pathologists and nephrologists. This FCGG network introduced a uniform renal biopsy request form, a well-structured report form of the renal pathology examination and a comprehensive list of renal pathology diagnoses. Method Following informed consent [99.5%] and in compliance with GDPR, the registration of the renal biopsies consists of basic categorical renal data, structured renal pathology information and the final clinical renal disease. Results In 2017 and 2018, 1385 renal biopsies were registered – 10.5 per million inhabitants per year; in addition, 28 patients had a repeat biopsy in the same time frame (2%). Of the pediatric patients ( age < 18 years; N=92; 6.6%), 23 had IgA nephropathy, 20 a minimal change disease and 15 another type of glomerulonephritis. The biopsy was reported as normal or non-diagnostic in 15 patients (16%) – the majority was clinically considered as glomerulonephritis. The spectrum of the adult population was quite similar across gender and age groups: 56% glomerulonephritis [= IgA nephropathy [19%] + FSGS [8%] + pauci-immune glomerulonephritis [7%] + other GN [22%] ), 10% tubulo-interstitial nephritis, 7% acute tubular necrosis [ATN], 7% diabetes mellitus, and 7% nephroangiosclerosis. Exceptions are pauci-immune glomerulonephritis as the most important renal disease in women aged 65 years and older, and lupus nephritis as the second most important glomerulonephritis in women aged 18-44 years. Only a small percentage of adult renal biopsies yielded no result (7%), clinically interpreted as glomerulonephritis in 50% of the cases. Conclusion The FCGG network has provided a more intense collaboration between renal pathologists and nephrologists mainly by standardizing the renal biopsy reading and reporting across all centers. More precise estimates of the prevalent renal diseases were provided for the first time; however, in order to get full information, renal diseases diagnosed by other techniques ( serology, genetic analysis ) should also be collected in the future. Efforts will be done to coordinate the clinical care of renal diseases, particularly the more rare renal diseases, and to offer access to new therapeutic molecules or new schemes, through this super-regional network.

scholarly journals The Paris System for Reporting Urinary Cytology: The Quest to Develop a Standardized Terminology

2016 ◽  
Vol 60 (3) ◽  
pp. 185-197 ◽  
Author(s):  
Güliz A. Barkan ◽  
Eva M. Wojcik ◽  
Ritu Nayar ◽  
Spasenija Savic-Prince ◽  
Marcus L. Quek ◽  
...  
Keyword(s):  
Working Group ◽  
Reporting System ◽  
Essential Elements ◽  
Urine Cytology ◽  
Urinary Cytology ◽  
Cytologic Examination ◽  
Diagnostic Categories ◽  
Standardized Reporting ◽  
Standardized Terminology ◽  
The Impact

The main purpose of urine cytology is to detect high-grade urothelial carcinoma (HGUC). With this principle in mind, The Paris System (TPS) Working Group, composed of cytopathologists, surgical pathologists, and urologists, has proposed and published a standardized reporting system that includes specific diagnostic categories and cytomorphologic criteria for the reliable diagnosis of HGUC. This paper outlines the essential elements of TPS and the process that led to the formation and rationale of the reporting system. The Paris System Working Group, organized at the 2013 International Congress of Cytology, conceived a standardized platform on which to base cytologic interpretation of urine samples. The widespread dissemination of this approach to cytologic examination and reporting of urologic samples and the scheme's universal acceptance by pathologists and urologists is critical for its success. For urologists, understanding the diagnostic criteria, their clinical implications, and the limitations of TPS is essential if they are to utilize urine cytology and noninvasive ancillary tests in a thoughtful and practical manner. This is the first international/inclusive attempt at standardizing urinary cytology. The success of TPS will depend on the pathology and urology communities working collectively to improve this seminal paradigm shift, and optimize the impact on patient care.

scholarly journals Epigenetic Modification Mechanisms Involved in Inflammation and Fibrosis in Renal Pathology

2018 ◽  
Vol 2018 ◽  
pp. 1-14 ◽  
Author(s):  
Jose Luis Morgado-Pascual ◽  
Vanessa Marchant ◽  
Raul Rodrigues-Diez ◽  
Nuria Dolade ◽  
Beatriz Suarez-Alvarez ◽  
...  
Keyword(s):  
Renal Damage ◽  
Epigenetic Modification ◽  
Critical Role ◽  
Epigenetic Modifications ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Epigenetic Mechanisms ◽  
Limited Effectiveness ◽  
Obesity Hypertension ◽  
Stage Renal Disease

The growing incidence of obesity, hypertension, and diabetes, coupled with the aging of the population, is increasing the prevalence of renal diseases in our society. Chronic kidney disease (CKD) is characterized by persistent inflammation, fibrosis, and loss of renal function leading to end-stage renal disease. Nowadays, CKD treatment has limited effectiveness underscoring the importance of the development of innovative therapeutic options. Recent studies have identified how epigenetic modifications participate in the susceptibility to CKD and have explained how the environment interacts with the renal cell epigenome to contribute to renal damage. Epigenetic mechanisms regulate critical processes involved in gene regulation and downstream cellular responses. The most relevant epigenetic modifications that play a critical role in renal damage include DNA methylation, histone modifications, and changes in miRNA levels. Importantly, these epigenetic modifications are reversible and, therefore, a source of potential therapeutic targets. Here, we will explain how epigenetic mechanisms may regulate essential processes involved in renal pathology and highlight some possible epigenetic therapeutic strategies for CKD treatment.

scholarly journals MO162IMPACT OF THE IMMUNOSUPPRESSIVE TREATMENT, X-RAY EXPOSITION AND RENAL PATHOLOGY ON OVARIAN RESERVE IN YOUNG WOMEN

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rasała Julia ◽  
Ciszewska Anna ◽  
Małgorzata Król ◽  
Mariusz Kusztal ◽  
Kościelska-Kasprzak Katarzyna ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Lupus Nephritis ◽  
Ovarian Reserve ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Enzyme Linked Immunosorbent Assay ◽  
X Rays ◽  
Childbearing Age ◽  
X Ray ◽  
The Past

Abstract Background and Aims Cyclophosphamide treatment and X-ray exposition in the area of the ovaries are proven to be the gonadotoxic factors in childbearing age women. Anti-Müllerian hormone (AMH) is regarded as a biomarker for ovarian reserve. Method The study included 167 consecutive premenopausal women attending Nephrology Clinic who gave informed consent and met exclusion criteria (past ovarian surgical procedure, PCOS, eGFR <30ml/min, irregular menstrual cycles). Clinical (renal pathology, smoking, X-rays exposition, eGFR standardized MDRD4, contraceptives) and demographic characteristics, as well as previous and current immunosuppressive therapies were recorded. Serum AMH levels were measured by Beckman Coulter’s Gen II enzyme linked immunosorbent assay (ELISA) kit; AMH levels were classified as low or normal/above age-adjusted reference levels (published norms). Statistical analysis included both regressive and non-regressive relationships between the studied clinical features. Due to the presumption of the remaining non-regression relationships between clinical factors, an original taxonomic method by Marczewski & Steinhaus was used instead of general linear modeling. Based on patient age, eGFR, renal pathology an ‘optimal’ segregation of patients was performed following the created classification tree (dendrogram). Results Median age of the patients was 33 (range 18-44). Median AMH concentration was 2,66 ng/ml; AMH levels were classified in 64 females as low (median 1,015) and in 103 as normal/above age-adjusted reference (median 4,04). Sixty one patients were treated with cyclophosphamide in the past and 45 underwent kidney transplantation. 92 women suffered from glomerulonephritis, 44 from lupus nephritis, 12 from interstitial kidney disease, 5 from ADPKD and 14 from other kidney diseases. Age, eGFR, pregnancies in the past as well as being the kidney transplant recipient were the coefficients strongly correlated with AMH level. Presence of lupus nephritis was correlated with lower levels of AMH in comparison to other renal diseases and in contrast to cyclophosphamide. X-ray exposition measured in cumulative lifetime dose was not correlated with AMH levels. Conclusion Although previous researchers suggested cyclophosphamide to be the strong gonadotoxic factor, our statistical analysis approach shows that lupus as the disease often treated with cyclophosphamide may be the lowering ovarian reserve factor itself. Further studies on this subject are still necessary.

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