Table 2.
Scoring methods for the histological evaluation of kidney biopsies
| Compartment | |
| Histological feature | |
| • Scoring method | |
| Glomerulus | |
| Total count glomeruli | |
| • All representative (adequately cross-cut) glomeruli together of 27 patients with sepsis | |
| Sclerotic glomeruli | |
| • Scored positive when total sclerosis of glomerulus is observed | |
| Glomerulitis | |
| • Yes: ≥ 10 leukocytes in glomerular capillaries | |
| • No: < 10 leukocytes in glomerular capillaries | |
| Increase in mesangial matrix | |
| • Stage 0: no mesangial matrix increase | |
| • Stage 1: up to 25% of non-sclerotic glomeruli affected (at least moderate matrix increase) | |
| • Stage 2: 26–50% of non-sclerotic glomeruli affected (at least moderate matrix increase) | |
| • Stage 3: > 50% of non-sclerotic glomeruli affected (at least moderate matrix increase) | |
| Leukocyte subsets | |
| • Number of CD3, CD20, CD68 and neutrophil elastase-positive cells in glomeruli divided by the total count of glomeruli, reported as mean number of positive cells/glomerulus | |
| Proliferating cells | |
| • Number of Ki-67 positive cells/glomerulus | |
| Myofibroblasts | |
| • Number of anti-α-SMA positive cells in glomeruli divided by the total count of glomeruli, reported as mean positive foci/glomerulus | |
| Thrombus formation | |
| • Martius, scarlet and blue positive cells in glomeruli divided by the total count of glomeruli, reported as mean positive foci/glomerulus | |
| Apoptosis | |
| • Number of Anti-caspase-3 positive cells in glomeruli divided by the total count of glomeruli, reported as mean positive foci/glomerulus | |
| Tubulointerstitium | |
| Tubulitis | |
| • Stage 0: no mononuclear cells in tubules | |
| • Stage 1: 1–4 mononuclear cells/tubular cross-section | |
| • Stage 2: 5–10 mononuclear cells/tubular cross-section | |
| • Stage 3: > 10 mononuclear cells/tubular cross-section | |
| Interstitial inflammation | |
| • Stage 0: no or hardly any interstitial parenchyma covered with mononuclear cells | |
| • Stage 1: 10–25% of interstitial parenchyma covered with mononuclear cells | |
| • Stage 2: 26–50% of interstitial parenchyma covered with mononuclear cells | |
| • Stage 3: > 50% of interstitial parenchyma covered with mononuclear cells | |
| Interstitial fibrosis | |
| • Stage 0: interstitial fibrosis tissue of up to 5% of total area | |
| • Stage 1: mild-interstitial fibrosis tissue of 6–25% of total area | |
| • Stage 2: moderate-interstitial fibrosis of 26–50% of total area | |
| • Stage 3: severe interstitial fibrosis of > 50% of total area | |
| Tubular atrophy | |
| • Stage 0: no tubular atrophy | |
| • Stage 1: atrophy in 0–25% of the tubules | |
| • Stage 2: atrophy in 26–50% of the tubules | |
| • Stage 3: atrophy of > 50% of the tubules | |
| Leukocyte subsets | |
| Number of CD3, CD20, CD68 and neutrophil elastase-positive cells | |
| • Stage 0: absent | |
| • Stage 1: focally present | |
| • Stage 2: diffusely present | |
| Proliferating cells | |
| • Number of Ki-67 positive cells/200 tubular epithelial cells | |
| Myofibroblasts | |
| anti-α-SMA positive cells present in tubulointerstitium | |
| • Stage 0: none | |
| • Stage 1: present in 0–25% of tubulointerstitium | |
| • Stage 2: present in 26–50% of tubulointerstitium | |
| • Stage 3: present in 51–75% of tubulointerstitium | |
| • Stage 4: present in > 75% of tubulointerstitium | |
| Thrombus formation | |
| • Number of martius, scarlet and blue total positive foci/2 mm2 | |
| Apoptosis | |
| Number of Anti-caspase-3 total positive cells present in tubulointerstitium | |
| • Stage 0: absent | |
| • Stage 1: present in 0–10% of total interstitial cells | |
| • Stage 2: present in 11–50% of total interstitial cells | |
| • Stage 3: present in > 50% of total interstitial cells | |
| Blood vessels | |
| Arteriolar intima sclerosis | |
| • Stage 0: no chronic vascular changes | |
| • Stage 1: vascular narrowing of up to 25% luminal area of arteries fibro-intimal thickening | |
| • Stage 2: vascular narrowing with 26–50% luminal area of arteries fibro-intimal thickening | |
| • Stage 3: vascular narrowing with 26–50% luminal area of arteries fibro-intimal thickening | |
| Arteriolar hyaline | |
| • Stage 0: no PAS-positive hyaline thickening | |
| • Stage 1: mild-to-moderate PAS-positive hyaline in at least one arteriole | |
| • Stage 2: moderate-to-severe PAS-positive hyaline thickening in more than one arteriole | |
| • Stage 3: severe PAS-positive hyaline thickening in many arterioles | |
| Intima arteritis | |
| • Stage 0: no arteritis | |
| • Stage 1: mild-to-moderate intimal arteritis in at least one arterial cross-section | |
| • Stage 2: severe intima arteritis with at least 25% luminal area lost in at least one arterial cross-section | |
| • Stage 3: arterial fibrinoid change and/or transmural arteritis with medial smooth muscle necrosis with lymphocytic inflammation | |
| Peritubular capillaritis | |
| • Stage 0: < 10% of capillaries contain inflammatory cells | |
| • Stage 1: > 10% of capillaries contain inflammatory cells, 3–4 mononuclear cells in peritubular capillary lumen | |
| • Stage 2: > 10% of capillaries contain inflammatory cells, 5–10 mononuclear cells in peritubular capillary lumen | |
| • Stage 3: if > 10% of capillaries contain inflammatory cells, > 10 mononuclear cells in peritubular capillary lumen |
PAS periodic acid–Schiff, SMA smooth muscle actin