International standardization in renal allograft biopsy reporting: a model for a new approach to renal pathology

As we prepare to enter a new century it is reasonable to ask whether our current classification system of renal pathology and descriptive approach to renal biopsy interpretation will be appropriate to the medicine of the future. Assessment of that special category of acute renal failure represented by early post-transplant biopsies is becoming much more quantitative, therapy-oriented, and pathogenesis-based. It would be highly beneficial to the field if similar changes occurred in our approach to native kidney biopsies. We need to provide tighter linkage between exciting new developments in the research laboratory and the clinical practice of renal pathology. In a field largely limited to traditional empirical therapies, we need to be developing new pathogenesis-oriented therapeutic approaches to native kidney disease based on the results of enlightened renal pathology research.