Nephropathology

The following projects are running in collaboration with the Department of Pathology, Haukeland University Hospital:

1. Collaborative projects with the Department of Pathology, Haukeland University Hospital, Bergen
Pathology services in the Western Norway Health Region "Patologi i Vest"): a centre for applied digitization. 

Increasing​g workload and labour shortages constitute a major challenge for pathology departments in the Western Norwegian Health Region. At the same time, digitization is revolutionizing the field of pathology. Never before has so much data been produced in pathology laboratories. Our project will develop methods to transform this data into meaningful clinical information and implement the results in practical applications. One of our focus areas is chronic kidney disease with the 2 sub-projects:

a. Quantification of kidney fibrosis

Any chronic kidney disease will develop fibrosis, an increase of connective tissue, over time. Fibrosis is a key prognostic marker. Quantification of fibrosis is therefore crucial to assess prognosis and to guide therapy. More information about the project.

People: Nazanin Mola (PhD candidate), Hrafn Weishaupt (Computer Scientist), Erlend Hodneland, Sabine Leh (Associate Professor)

b. Automatic classification of glomerular lesions

Glomeruli are capillary tufts filtering waste products from the blood and forming urine together with the tubular system. Glomeruli can be affected by a multitude of diseases and show very diverse lesions. Several deep-learning strategies will be evaluated for e.g., the detection, segmentation, clustering, and classification of glomerular structures from biopsy images. More information about the project.

People: Hrafn Weishaupt (Computer Scientist), Justinas Besusparis (Pathologist), Nazanin Mola (PhD candidate), Sabine Leh (Associate Professor)

2. Polyvinylpyrrolidone deposition disease

Intravenous use of an oral methadone syrup containing PVP K90 has led to PVP deposition in patients with opioid addiction and IVDU, in some patients likely resulting in severe disease and fatal outcomes. The project investigates the pathological and clinical findings of 33 patients with PVP deposition. A specific focus is PVP-related chronic kidney disease.

Funding: Helse Vest PhD grant

People: Ida Stalund (PhD candidate), Einar Svarstad, Friedemann Leh, Heidi Grønseth, Hans-Peter Marti, Sabine Leh

Publications:

Kristoffersen, A. H., T. K. Bjanes, S. Jordal, S. Leh, F. Leh and E. Svarstad (2016). "Polyvinylpyrrolidone induced artefactual prolongation of activated partial thromboplastin times in intravenous drug users with renal failure." J Thromb Haemost 14(5): 936-939.

Stalund, I. V., G. N. Riise, F. Leh, T. K. Bjånes, L. Riise, E. Svarstad and S. Leh (2021). "Case Report: Polyvinylpyrrolidone deposition disease from repeated injection of opioid substitution drugs: report of a case with a fatal outcome." F1000Res 10: 300.

Leh, F., I. V. Stalund, T. K. Bjånes, C. Ohldieck, E. Svarstad and S. Leh (2021). "Polyvinylpyrrolidone deposition disease in patients with intravenous opioid use: a case series." Hum Pathol 116: 102-111.

Stalund, I. V., H. Grønseth, F. P. Reinholt, E. Svarstad, H. P. Marti and S. Leh (2022). "Chronic Kidney Disease from Polyvinylpyrrolidone Deposition in Persons with Intravenous Drug Use." Clin J Am Soc Nephrol 17(4): 518-526.

3. Complement C5b-9 activation in kidney disease

Complement activation represents a well-described key pathogenic mechanism underlying inflammatory diseases affecting the kidney. In order to learn more about the significance of C5b-9 deposition, we evaluate the expression of C5b-9 in formalin-fixed, paraffin embedded (FFPE) non-neoplastic kidney biopsies with both glomerular, tubulointerstitial and vascular diseases by means of immunohistochemistry and quantitative image analysis.

People: Ole Petter Nordbø (PhD candidate), Ga Kei Tam, Sabine Leh, Hans-Peter Marti

4. Kidney Biopsy Codes for Pathologists KBC

Website

Information gathered in kidney biopsy registries benefits research, teaching and policy-making. Nowadays registries are mainly using locally developed classifications (sometimes with corresponding codes) for registration of pathology diagnoses. Because of the variety in classifications and codes, comparison, exchange or accumulation of data is hampered. Consequently, there is a great need for a more standardized, universally applicable terminology and interoperable coding for kidney biopsy codes. The KBC project aims to provide a complete and structured list of terminology and codes applicable to kidney biopsies.

People: Amélie Dendooven (Belgium), Sabine Leh (Norway)

Publications:

Dendooven, A., H. Peetermans, M. Helbert, T. Q. Nguyen, N. Marcussen, M. Nagata, L. Gesualdo, A. Perkowska-Ptasinska, C. Capusa, J. M. Lopez-Gomez, C. Geddes, M. A. Abdul-Hamid, M. Segelmark, R. Yahya, M. Garau, R. Villanueva, A. Dorman, S. Barbour, R. Cornet, H. Hopfer, K. Amann and S. Leh (2021). "Coding practice in national and regional kidney biopsy registries." BMC Nephrol 22(1): 193.

Leh, S. and A. Dendooven (2022). "Systematic reporting of medical kidney biopsies." Clin Kidney J 15(1): 21-30.

Leh, S., Dendooven, A. „Kidney biopsy codes for pathologists“. Nephrologie 17, 376–385 (2022).