Department of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Curr Opin Nephrol Hypertens. 2021 May 1;30(3):280-286. doi: 10.1097/MNH.0000000000000701.
To review recent efforts to develop uniformity and precision in defining individual glomerular histologic and ultrastructural lesions and proposals for developing greater uniformity in reporting of glomerular diseases.
Over the past 2 decades, scoring systems for multiple glomerular diseases have emerged, as have several consortia for the study of glomerular diseases. However, one important limitation faced by renal pathologists and nephrologists has been a lack of uniformity and precision in defining the morphologic lesions seen by light and electron microscopy on which the scoring systems are based. In response to this, the Renal Pathology Society organized a working group that over 4 years arrived at consensus definitions for many such lesions. These definitions can be applied within the context of scoring systems for different glomerular diseases, and recently proposed reporting systems based on pathogenic categories and for defining the overall severity of chronic changes.
From extensive discussions a panel of 13 renal pathologists reached consensus in defining 47 individual glomerular lesions seen on light microscopy and 56 glomerular lesions and key normal structures seen by electron microscopy. Validation of the impact of these consensus definitions on interobserver agreement in lesion identification is currently underway.
回顾近年来在定义个体肾小球组织学和超微结构病变方面实现一致性和精确性的努力，以及在肾小球疾病报告中实现更大一致性的建议。
在过去的 20 年中，已经出现了多种用于多种肾小球疾病的评分系统，以及多个用于肾小球疾病研究的联合会。然而，肾脏病理学家和肾病学家面临的一个重要限制是，在定义评分系统所依据的光镜和电子显微镜下所见形态病变方面缺乏一致性和精确性。为了应对这一问题，肾脏病理学会组织了一个工作组，该工作组在 4 年的时间里就许多此类病变达成了共识定义。这些定义可以应用于不同肾小球疾病的评分系统中，以及最近基于致病类别和定义慢性病变整体严重程度的报告系统。
通过广泛讨论，由 13 名肾脏病理学家组成的专家组就光镜下所见的 47 种肾小球病变和电子显微镜下所见的 56 种肾小球病变及关键正常结构达成了共识定义。目前正在验证这些共识定义对病变识别中观察者间一致性的影响。
