Renal Standardization Project
The Renal Standardization Project was developed with the vision of improving the diagnosis and, as a consequence, the clinical outcomes of glomerular diseases in dogs.
Mission and Goals
- To develop 2 Diagnostic Renal Pathology Centers (DRPC), one in the USA and one in Europe, with the capability to process and evaluate kidney biopsies using light, transmission electron, and immunofluorescent microscopy.
- To develop a prototype classification scheme for glomerular disease in dogs.
- To prospectively collect clinical data to be paired with the renal pathologic findings to develop a system of renal diagnosis based on both clinical and pathologic findings.
- To evaluate the ability of the renal diagnosis to predict clinical outcomes and, ultimately, facilitate treatment recommendations (subject of a subsequent proposed clinical trial).
- We also plan to prepare continuing education manuscripts to be published in various wide-read journals on the use of renal biopsies. These articles will include information on the background of renal pathology and how it has developed as a consequence of the WSAVA RSP.
Why do we care?
Glomerular disorders are an important cause of kidney disease in dogs and cats, but their diagnostic evaluation, classification, and management remain enigmatic and uncharacterized compared to other renal pathology. Accurate diagnosis of a patient's glomerular disease provides insights into the disorder's pathogenesis and prognosis, as well as guidelines for appropriate treatment. In human beings, specific glomerular diseases are characterized (and thus are identified) by their light microscopic, immunopathologic, and electron microscopic features which are correlated with the particular clinical and clinicopathologic findings that are exhibited by affected patients.
The purpose of this initiative is to employ the use of all three diagnostic modalities, used in human nephropathology, to accurately characterize glomerular disease in proteinuric dogs, and to relate these findings to clinicopathologic presentation and outcome. This is achieved by establishing an international network of cooperating diagnostic renal pathology service centers to systematically evaluate tissue specimens obtained from proteinuric dogs world-wide and collect information about the clinical and clinicopathologic features of their illnesses. The long-term goal of this study is to better understand and evaluate and thus optimize the medical management of dogs with proteinuric renal disorders by identifying distinct glomerular diseases for which specific prognoses and therapeutic guidelines can be provided.
The Renal Standardization Group is still working on its project. It conducts lectures at specific specialty conferences, and is ready to publish scientific papers in renowned magazines in the area. For more practical information for the day to day veterinary practice, we need to be a little more patient and await the general guidelines in diagnosis and treatment that this study will eventually be able to provide.
The final outcome of this project will be provided.
A publication of a standardized system for classification of pathological lesions in canine glomeruli that is accepted and adopted throughout the world and that is based on a refinement of the system currently used in human medicine.
A description of the prevalence of precisely defined canine protein-losing kidney diseases in a large population of dogs and the correlation of the history, physical examination findings, and clinical laboratory data with the pathological disease classification.
The production of an atlas of glomerular diseases of the dog where the agreed standardized histopathological classification will be clearly presented together with the data on prevalence of the diseases and the clinical correlates of each major disease. This atlas will serve as a as an educational tool and will ensure widespread dissemination of the results of the project throughout the world.
The definition of the natural history of progression of the canine kidney diseases defined in the cross-sectional part of this study by longitudinal follow-up of the cases from which biopsy material was submitted. These follow-up data will define the prognosis of each disease when dogs are subjected to current methods of standard care for protein-losing kidney disease.