Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH.
J Vet Intern Med. 2013 Nov-Dec;27 Suppl 1:S10-8. doi: 10.1111/jvim.12226.
Human renal biopsies are routinely evaluated with light microscopy (LM) using a panel of histologic stains, transmission electron microscopy (TEM), and immunofluorescence (IF) microscopy to obtain a diagnosis. In contrast, the pathologic evaluation of glomerular disease in veterinary medicine has relied mostly on LM and was of limited utility. To address this problem, recently established veterinary renal diagnostic centers have adopted methods used in human nephropathology for evaluation of renal biopsies. Three broad categories of disease, which have the greatest implications for clinical management of proteinuric dogs, have been established and include amyloidosis, immune complex-mediated glomerulonephritis (ICGN), and non-ICGN.
To demonstrate histopathologic, ultrastructural, and IF findings in renal biopsy specimens that experienced veterinary nephropathologists utilize to make accurate and clinically useful diagnoses in dogs with proteinuric glomerular disease and to provide guidelines for the proper evaluation of renal biopsies.
Renal biopsy specimens were routinely examined by LM, IF, and TEM. Samples were reviewed by members of the World Small Animal Veterinary Association Renal Standardization Study Group to identify lesions that were diagnostic for, or suggestive of, the presence of immune complexes (IC) or amyloidosis in all modalities. Ten guidelines for renal biopsy evaluation were formulated.
Each method of investigation contributed important findings that were integrated to make an accurate final morphological diagnosis. The guidelines were validated by an independent group of veterinary pathologists.
Routine evaluation of renal biopsies with LM, TEM, and IF is feasible and necessary for making accurate, morphologic diagnoses that can be used to guide clinical management of dogs with glomerular disease.
人体肾活检通常通过光镜（LM）检查，使用一系列组织学染色、透射电子显微镜（TEM）和免疫荧光（IF）显微镜来获得诊断。相比之下，兽医肾小球疾病的病理评估主要依赖于 LM，且作用有限。为了解决这个问题，最近成立的兽医肾脏诊断中心已经采用了人类肾病病理学中用于评估肾活检的方法。已经确定了三大类疾病，它们对蛋白尿犬的临床管理具有最大的影响，包括淀粉样变性、免疫复合物介导的肾小球肾炎（ICGN）和非 ICGN。
展示兽医肾病学家用于对患有蛋白尿性肾小球疾病的犬进行准确且具有临床意义的诊断的肾活检标本的组织病理学、超微结构和 IF 发现，并提供适当评估肾活检的指南。
肾活检标本常规进行 LM、IF 和 TEM 检查。由世界小动物兽医协会肾脏标准化研究组的成员对标本进行复查，以识别所有方式下对免疫复合物（IC）或淀粉样变性的存在具有诊断意义或提示意义的病变。制定了 10 条肾活检评估指南。
每种研究方法都提供了重要的发现，这些发现被整合在一起以做出准确的最终形态学诊断。这些指南得到了一组独立的兽医病理学家的验证。
对肾活检进行 LM、TEM 和 IF 的常规评估是可行且必要的，可用于做出准确的形态学诊断，从而指导患有肾小球疾病的犬的临床管理。
