Our Kidneys may appear to us as two small bean shaped organs inside our body but the value associated with them cannot be explained in words. Having said that, I am pretty sure, very few will tend to disagree with this, fully aware of what complications, a kidney failure can cause. When we talk about kidneys, we subsequently hear about common medical terminologies associated with kidneys like Kidney Stones, Kidney Transplant etc. But few of us would have heard about Nephropathology. Nephropathology is a highly specialized field of surgical pathology. For simple understanding, it deals with the diagnosis and characterisation of kidney diseases which are non-tumour like or non-cancerous, if it can be put that way. It is considered as quite a challenging field by nephrologists because it calls for the evaluation of renal biopsies (tissue samples) towards identifying serious nephrological disorders.
Renal biopsies are processed by a Neuropathologist for microscopic evaluation. With Nephropathology involving percutaneous renal biopsy, it has become easier to detect renal diseases at its early stages. It has also made the process much faster as compare to the process of autopsy pathology, practiced earlier. Nephropathology has also proved to be an ideal surface in applying two very interesting and productive techniques in Immunohistochemistry (IHC) and Electron Microscopy (EM). These techniques have become immensely helpful in identifying diseases connected with glomeruli (filters associated with kidneys). Identifying Medical Renal Diseases like Nephritic Syndrome, acute kidney injury, isolated haematuria/proteinuria, and graft dysfunction, in the case of a renal transplant recipient, has become simpler with Nephropathology. However, there are many parameters that are vital for the study of the renal biopsy samples like the size and type of renal biopsy sample. Needless to say there should be zero compromise on the expertise of the staff for proper evaluation. In the developed countries, there are dedicated Nephropathology Laboratories which are well equipped with all the necessary diagnostic equipment for complete evaluation of renal biopsy samples. However, Nephropathology receives little attention in most of the surgical pathology laboratories in the developing nations. Not just collection of sample matters here. Extensive care must be taken to transport these samples to the Laboratories for testing. These should strictly adhere to all the necessary guidelines laid down by United Nations and World Health Organization for transporting biological substance for evaluation. There are numerous challenges in establishing a world class Nephropathology centre. These can be overcome by lesser equipped labs and well –equipped labs collaborating and working in tandem.