Component indices:
(1) glomeruli
(2) tubules and interstitium
(3) vascular
Glomerular features:
(1) mesangial hypercellularity
(2) matrix increase
(3) glomerular sclerosis
(4) capillary narrowing and/or disruption
(5) cellular crescents
(6) fibrous adhesions
Tubular and interstitial (tubulointerstitial) features:
(1) tubular dilatation
(2) vacuolization
(3) atrophy
(4) erythrocyte casts
(5) proteinaceous casts
(6) interstitial cellular infiltration, edema and/or fibrosis
Vascular features:
(1) interlobular artery sclerosis
(2) interlobular artery hyalinization
(3) interlobular artery thickening
(4) interlobular medial hypertrophy
(5) arteriolar sclerosis
(6) arteriolar hyalinization
(7) arteriolar thickening
|
Histologic Change
|
Points
|
|
no change
|
0
|
|
mild change
|
1
|
|
moderate change
|
2
|
|
severe change
|
3
|
glomerular index =
= SUM(points for all 6 parameters)
tubulointerstitial index =
= SUM(points for all 6 parameters)
vascular index =
= SUM(points for all 7 parameters)
Interpretation:
• minimal indices: 0
• maximal glomerular index: 18
• maximal tubulointerstitial index: 18
• maximal vascular index: 21
• The higher the index, the greater the extent of involvement.
