Table 2.


Table 2.  Evaluation of the degree of severity of chronic glomerulopathies, in large populations of cats, based on   several key points of morphological changes in glomeruli and the cortical layer of the kidney.

Type of morphological changes

Visual  morphologic  changes, light microscopy

Norma*

Mild  degree *

Mean  degree *

Severe degree*

I.

Proliferation of cells in glomerule.

1) Intracapillary proliferation of mesangium.

2)  Intracapillary proliferation and  swelling   endotheliocyte.

Hypercellularity and  hypertrophy of glomrule

Number of changed  glomeruli   microscopic field during  magnification power *40

 

Number of   cell nucleus  entering into the composition of nodal part of glomerule

Number of changed  glomeruli   microscopic field during  magnification power *40

 

Number of   cell nucleus  entering into the composition of nodal part of glomerule

Number of changed  glomeruli  microscopic field during  magnification power *40

 

Number of   cell nucleus  entering into the composition of nodal part of glomerule

Number of changed  glomeruli   microscopic field during  magnification power *40

 

Number of   cell nucleus  entering into the composition of nodal part of glomerule

no

45-75

 

1-3

 

80-100

 

2-7

 

110-140

All glomeuli are changed to some degree

 

More  than 140

3) Extracapillary proliferation of  epithelial cells of external layer of   Bowman's capsule

Cellular  and/or  proteinaceous  « demilunes»  segmental  or  circular  type and/or  hyalinosis  (with  thickening) of glomerule capsule with  obliteration of its lumen and   compression of capillary loops.

Number of changed  glomerule   microscopic field during  magnification power *40

 

Number of changed  glomerule   microscopic field during  magnification power *40

 

Number of changed  glomerule   microscopic field during  magnification power *40

 

Number of changed  glomerule   microscopic field during  magnification power *40

 

no

1-2

3-5

 

All glomeuli are changed to some extent

 

4) Segmentation of glomerule loops as a result of:

à. Accumulation of  membrane material and/or mesangium matrix.

á. Increase of the number of mesangium cells.

1. “lobulation” of glomeule

2. “palmation” of glomerule

 

no

1-2

3-5

All glomeuli are changed to some degree

 

II.

Infiltration of cortical layer by inflammatory cells.

 

Infiltration of cortical layer with agranulocytes:  diffuse and/or focal (perivascular (around  interstisial vessels),  periglomerular** and/or intraglomerular***).

Average number of   agranulocytes   in 4-5  microscopic field   magnification power *40

 

Average number of   agranulocytes   in 4-5  microscopic field   magnification power *40

Average number of   agranulocytes   in 4-5  microscopic field   magnification power *40

Average number of   agranulocytes   in 4-5  microscopic field   magnification power *40

no

10-20

20-40

More than 50 (entirely)

III.

Fibrinoid necrosis of capillary loops of glomerule with following fibrosis (sclerosis)of glomeruli.

 

Replacement of various structures of glomerule with  connective tissue.

no

Number of changed  glomerule   microscopic field during  magnification power *40

 

Percentage of  fibrinoid necrosis and/or replacement of various structures of glomerule with  connective tissue

Number of changed  glomerule   microscopic field during  magnification power *40

 

Percentage of  fibrinoid necrosis and/or  replacement of various structures of glomerule with  connective tissue

Number of changed  glomerule   microscopic field during  magnification power *40

 

Percentage of  fibrinoid necrosis and/or  replacement of various structures of glomerule with  connective tissue

2-4

from 20 to 40

5-7

from 40 to 70

More than 7

 

  This classification can only be used for quantitative staging of the severity of glomerulopathies in the population of cats in general, but not for differentiation of glomerulopathies by morphological forms (e.g. minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranoproliferative glomerulonephritis and so on).

*Histosection thickness is 3 – 4 microns. ** Focal agranulocytes infiltration around glomeruli. *** Infiltration with agranulocytes of nodal part of the glomerule.