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Abstract
ABSTRACT: It was evaluated the different methodologies for glomerular enumeration described in the literature in a quantitative, double-blind study on the number of glomeruli present in kidney biopsy specimens obtained using a Tru-cut-type biopsy needle. Eighteen samples were taken (n=18) from various regions of canine kidneys harvested immediately after euthanasia. Sample collection was carried out using Tru-cut-type, semi-automated, 16 gauge needles. Reading and evaluation of the specimens were performed independently by four researchers by means of eye loupe inspection, light microscopy, light microscopy with a reduced condenser aperture, and dissection microscopy. Samples were also subjected to histopathological evaluation for comparison purposes. There was no inter-researcher variation for any of the tested methods. The glomerular counts obtained using light microscopy with reduced condenser aperture were similar to those reported in the histopathological evaluation (P=0.44);whereas, the other glomerular enumeration methods yielded significantly lower counts when compared to the histopathological analysis (eye loupe inspection: P<0.01; conventional light microscopy: P=0.02; dissection microscopy: P<0.01).Light microscope with lowering of the condenser lens delivers better results than conventional light microscopy and eye loupe inspection. Results obtained using dissection microscopy and eye loupe inspection did not correlate well with those provided by histopathological evaluation; consequently, these two methods should be avoided.
Highlights
Renal biopsy is as an important tool to determine the cause of the disease in patients with chronic kidney disease; it helps determine prognosis and choose the most appropriate treatment protocol
Proper assessment of canine kidney biopsy specimens with glomerular diseases is believed to require about 2 to 3 samples of renal tissue to allow a precise histological evaluation (HUSSAIN et al, 2010; CIANCIOLO et al, 2013)
All the glomerular enumeration methods used in this study were able to deliver estimations of Ciência Rural, v.49, n
Summary
Renal biopsy is as an important tool to determine the cause of the disease in patients with chronic kidney disease; it helps determine prognosis and choose the most appropriate treatment protocol. Histological examination of kidney tissue obtained by biopsy is considered to be the gold standard for the definitive diagnosis of kidney diseases (VADEN et al, 2005; KARAM et al, 2010; LEES et al, 2011). Proper assessment of canine kidney biopsy specimens with glomerular diseases is believed to require about 2 to 3 samples of renal tissue to allow a precise histological evaluation (HUSSAIN et al, 2010; CIANCIOLO et al, 2013). Additional tissue fragments are required to carry out electron and immunofluorescence microscopy analyses to enable a definitive diagnosis (CIANCIOLO et al, 2013). There are several methods to estimate the quality and number of glomeruli These methods include loupe (10X) inspection, dissection microscopy (WALKER 2009; LEES et al 2011), and conventional light microscopy (VADEN 2004; VADEN et al, 2005; LEES et al, 2011)
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