History and future of renal pathology

D'Agati and Mengel look into the past and peek into the future of renal pathology:

• Before 1950s most studies of renal pathology were performed in autopsy cases. Little could be appreciated from predominantly end stage kidneys.
• After introduction of percutaneous renal biopsy in 1951, renal pathology began taking significance role in clinical nephrology. Clinical-pathologic correlation, started at University of Chicago by Pirani, Kark and Muehrcke, leaded to deeper understanding of disease process.
• Optimization of histological technique, the use of immunofluorescence and electron microscope helped discovery of many renal diseases which have immunological origin or ultrastructural abnormalities.
• Ciba symposium in 1961 helped establish renal pathology as a significant discipline recognized by nephrologists.
• 1st edition of Heptinstall's Pathology of the Kidney was published in 1966.
• The Renal Pathology Society (RPS) started as Renal Pathology Club in 1977.
• Renal pathology became indispensable to the nephrology community. This was evident by the inclusion of renal pathology program in annual meeting of American Society of Nephrology (ASN), renal pathologists as editorial board of major nephrology journals and presidents of nephrology societies.
• In molecular age renal biopsy is a tool to validate non-invasive diagnostic molecular methods such as urine proteomics. The authors believe that these methods are unlikely to replace renal biopsy but will be used in the integrated way to derive etiology-based diagnosis.