Impact of Consensus Definitions on Identification of Glomerular Lesions by Light and Electron Microscopy

• Published in: Kidney international reports 2022-01, Vol.7 (1), p.78-86
• Main Authors: Haas, Mark, Mirocha, James, Amann, Kerstin, Bajema, Ingeborg M., Barisoni, Laura, Becker, Jan Ulrich, Jennette, J. Charles, Joh, Kenuske, Ljubanovic, Danica Galesic, Roberts, Ian S.D., Roelofs, Joris J., Sethi, Sanjeev, Suarez, Raul, Zeng, Caihong, Seshan, Surya V.
• Format: Article
• Language: English
• Subjects: Clinical Research; electron microscopy; glomerulonephritis; glomerulus; kidney biopsy; renal pathology
• ISSN: 2468-0249; 2468-0249
• DOI: 10.1016/j.ekir.2021.10.014

In 2020, a working group of 13 renal pathologists published consensus definitions for 47 individual glomerular lesions found on light microscopy (LM) and 47 glomerular lesions and 9 normal structures found on electron microscopy (EM). To test the impact of these definitions on identification of these lesions and structures, 2 surveys were circulated to all members of the Renal Pathology Society (RPS), each having 32 images (19 LM, 13 EM) and accompanying questions with 5 multiple-choice answers, one being the consensus choice of the working group. The first survey (survey 1 [S1]), answered by 297 RPS members, was sent in September 2020, before publication of the consensus definitions. The second (survey 2 [S2]), with images of the same lesions and structures (but not the same images) and the same questions and multiple choices in different order, was sent in April 2020, 5 months after the publication of the definitions. S2 was taken by 181 RPS members; 64% also took S1 and 61% reported having read the definitions paper (def. paper). Mean agreement with the consensus answers increased modestly between the 2 surveys (65.2% vs. 72.0%, P = 0.097); the increase was greater and significant when only respondents to S2 who read the def. paper were considered (65.2% vs. 74.8%, P = 0.026). Furthermore, in S2 agreement with consensus answers was greater among respondents who read this paper versus those who did not (66.9% vs. 74.8%, P < 0.0001). Publication of the consensus definitions modestly improved interobserver agreement in identification of glomerular lesions. [Display omitted]