Prognostic value of simple measurement of chronic damage in renal biopsy specimens

Nephrol Dial Transplant. 2001 Jun;16(6):1163-9. doi: 10.1093/ndt/16.6.1163.


Background: A simple method of measurement of chronic damage in renal biopsy specimens would be useful in clinical management, prognosis, comparisons between different centres and trials.

Methods: An interactive image analysis system was used to outline and measure areas of chronic damage in 247 renal biopsy specimens to give an index of chronic damage, expressed as a percentage of cortical cross-sectional area. Prognostic value was analysed by the Kaplan-Meier method to study time between biopsy and onset of permanent dialysis.

Results: There was no significant bias between measurements by the same observer or different observers. The index of chronic damage ranged from 0 to 90%. Increasing severity of chronic damage was associated with shortened renal survival. Each increase of 10% in the index increased the hazard ratio of risk of permanent dialysis by 1.5 times (95% confidence interval 1.4-1.7, P<0.001).

Conclusions: A simple measure of chronic damage was a powerful indicator of prognosis. This is likely to be clinically useful in routine practice and trials.

MeSH terms

  • Biopsy / methods
  • Creatinine / blood
  • Disease Progression
  • Follow-Up Studies
  • Glomerulonephritis, IGA / pathology
  • Humans
  • Image Processing, Computer-Assisted
  • Kidney Cortex / pathology*
  • Kidney Diseases / pathology*
  • Kidney Diseases / physiopathology
  • Kidney Diseases / therapy
  • Kidney Failure, Chronic / pathology*
  • Kidney Failure, Chronic / physiopathology
  • Kidney Failure, Chronic / therapy*
  • Peritoneal Dialysis
  • Predictive Value of Tests
  • Prognosis
  • Renal Dialysis
  • Retrospective Studies
  • Time Factors


  • Creatinine