ARCHETYPE Microscopy renal biopsy non neoplastic (openEHR-EHR-CLUSTER.microscopy_renal_biopsy_non_neoplastic.v0)

ARCHETYPE IDopenEHR-EHR-CLUSTER.microscopy_renal_biopsy_non_neoplastic.v0
ConceptMicroscopy renal biopsy non neoplastic
DescriptionMicroscopic findings related to a non-neoplastic renal biopsy
UseTo record detailed findings about microscopic examination of tissue related to glomerular, tubulointerstitial and vascular renal diseases. Use as a component archetype in the context of a suite of archetypes that make up a histopathology report i.e. OBSERVATION.lab_test.histopathology
MisuseNot designed to be used within any other archetype other than OBSERVATION.lab_test.histopathology.
PurposeTo record detailed findings about a non-neoplastic renal biopsy
ReferencesChang A, Gibson IW, Cohen AH, Weening JW, Jennette JC, and Fogo AB (2012). A position paper on standardizing the nonneoplastic kidney biopsy report. Hum Pathol 43:1192-1196.

Farris AB, Adams CD, Brousaides N, Della Pelle PA, Collins AB, Moradi E, Smith RN, Grimm PC, and Colvin RB (2011). Morphometric and visual evaluation of fibrosis in renal biopsies. J Am Soc Nephrol 22:176-186.

Berden AE, Ferrario F, Hagen EC, Jayne DR, Jennette JC, Joh K, Neumann I, Noel LH, Pusey CD, Waldherr R, Bruijn JA, and Bajema IM (2010). Histopathologic classification of ANCA-associated glomerulonephritis. J Am Soc Nephrol 21:1628-1636.

Koss MN. Handling and interpretation of the medical renal biopsy (2014). Methods Mol Biol; 1180: 323-336

Racusen LC, Solez K, Colvin RB et al. The Banff 97 working classification of renal allograft pathology. Kidney International 1999; 55: 713-723

Solez K, Colvin RB, Racusen LC et al. Banff 07 classification of renal allograft pathology: Updates and future directions. American Journal of Transplantation 2008; 8: 753-760
Jennette JC, D'Agati VD, Olson JL, Silva F. Heptinstall's Pathology of the Kidney. LWW, Philadelphia: 2014;

Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004 Feb;15(2):241-50. Erratum in: J Am Soc Nephrol. 2004 Mar;15(3):835-6.

Working Group of the International IgA Nephropathy Network and the Renal Pathology Society, Roberts IS, Cook HT, Troyanov S, Alpers CE, Amore A, Barratt J, Berthoux F, Bonsib S, Bruijn JA, Cattran DC, Coppo R, D'Agati V, D'Amico G, Emancipator S, Emma F, Feehally J, Ferrario F, Fervenza FC, Florquin S, Fogo A, Geddes CC, Groene HJ, Haas M, Herzenberg AM, Hill PA, Hogg RJ, Hsu SI, Jennette JC, Joh K, Julian BA, Kawamura T, Lai FM, Li LS, Li PK, Liu ZH, Mackinnon B, Mezzano S, Schena FP, Tomino Y, Walker PD, Wang H, Weening JJ, Yoshikawa N, Zhang H. The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility. Kidney Int. 2009 Sep;76(5):546-56.

Copyright© Nasjonal IKT HF
AuthorsAuthor name: Sabine Leh
Organisation: Haukeland University Hospital
Email: sabine.leh@helse-bergen.no
Date originally authored: 2014-06-08
Other Details LanguageAuthor name: Sabine Leh
Organisation: Haukeland University Hospital
Email: sabine.leh@helse-bergen.no
Date originally authored: 2014-06-08
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/4.0/., custodian_organisation=Nasjonal IKT, references=Chang A, Gibson IW, Cohen AH, Weening JW, Jennette JC, and Fogo AB (2012). A position paper on standardizing the nonneoplastic kidney biopsy report. Hum Pathol 43:1192-1196. Farris AB, Adams CD, Brousaides N, Della Pelle PA, Collins AB, Moradi E, Smith RN, Grimm PC, and Colvin RB (2011). Morphometric and visual evaluation of fibrosis in renal biopsies. J Am Soc Nephrol 22:176-186. Berden AE, Ferrario F, Hagen EC, Jayne DR, Jennette JC, Joh K, Neumann I, Noel LH, Pusey CD, Waldherr R, Bruijn JA, and Bajema IM (2010). Histopathologic classification of ANCA-associated glomerulonephritis. J Am Soc Nephrol 21:1628-1636. Koss MN. Handling and interpretation of the medical renal biopsy (2014). Methods Mol Biol; 1180: 323-336 Racusen LC, Solez K, Colvin RB et al. The Banff 97 working classification of renal allograft pathology. Kidney International 1999; 55: 713-723 Solez K, Colvin RB, Racusen LC et al. Banff 07 classification of renal allograft pathology: Updates and future directions. American Journal of Transplantation 2008; 8: 753-760 Jennette JC, D'Agati VD, Olson JL, Silva F. Heptinstall's Pathology of the Kidney. LWW, Philadelphia: 2014; Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004 Feb;15(2):241-50. Erratum in: J Am Soc Nephrol. 2004 Mar;15(3):835-6. Working Group of the International IgA Nephropathy Network and the Renal Pathology Society, Roberts IS, Cook HT, Troyanov S, Alpers CE, Amore A, Barratt J, Berthoux F, Bonsib S, Bruijn JA, Cattran DC, Coppo R, D'Agati V, D'Amico G, Emancipator S, Emma F, Feehally J, Ferrario F, Fervenza FC, Florquin S, Fogo A, Geddes CC, Groene HJ, Haas M, Herzenberg AM, Hill PA, Hogg RJ, Hsu SI, Jennette JC, Joh K, Julian BA, Kawamura T, Lai FM, Li LS, Li PK, Liu ZH, Mackinnon B, Mezzano S, Schena FP, Tomino Y, Walker PD, Wang H, Weening JJ, Yoshikawa N, Zhang H. The Oxford classification of IgA nephropathy: pathology definitions, correlations, and reproducibility. Kidney Int. 2009 Sep;76(5):546-56. , current_contact=Sabine Leh, Haukeland University Hospital, sabine.leh@helse-bergen.no, original_namespace=no.nasjonalikt, original_publisher=Nasjonal IKT, custodian_namespace=no.nasjonalikt, MD5-CAM-1.0.1=45ED5CF84F253443E59D1D1B2084F07C, build_uid=be1b5cc5-9918-4c14-99ff-1709f66d79f4, revision=0.0.1-alpha}
Keywordshistopathology, pathology, renal, laboratory
Lifecyclein_development
UID324df9ac-fdc6-4e36-ae8f-b78755354d87
Language useden
Citeable Identifier1013.1.2859
Revision Number0.0.1-alpha
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  •  Coded Text
    • Present [Cortical tissue present.]
    • Absent [Cortical tissue absent.]
    • Indeterminate [Presence of cortical tissue has not been determined.]
  •  Quantity
    Property: Length
    Units: mm
  •  Proportion
    • Percent
    Integral
    Assumed value: false
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0007], code=at0007, itemType=ELEMENT, level=2, text=Medulla, description=Medullary tissue present, alternatively core length with medullary tissue, alternatively proportion of medullary tissue in relation to the core with renal tissue., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Present [Medullary tissue present.]
    • Absent [Medullary tissue absent.]
    • Indeterminate [Presence of medullary tissue has not been determined.]
  •  Quantity
    Property: Length
    Units: mm
  •  Proportion
    • Percent
    Integral
    Assumed value: false
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Renale capsule, description=A statement whether the renal capsule is present., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0012], code=at0012, itemType=ELEMENT, level=2, text=Other tissue elements, description=Description of other tissue elements, e.g. muscle tissue., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Sceletal muscle and/or fat tissue and/or connective tissue [Sceletal muscle and/or fat tissue and/or connective tissue present.]
    • Renal pelvis mucosa [Renal pelvis mucosa present.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015], code=at0015, itemType=CLUSTER, level=1, text=Glomeruli, description=Description of glomerular changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0016], code=at0016, itemType=ELEMENT, level=2, text=Glomeruli, description=The maximum number of glomeruli irrespective of size present in one section; structures consisting of Bowman's capsule with empty Bowman's space are excluded., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0017], code=at0017, itemType=ELEMENT, level=2, text=Scorable glomeruli, description=The number of glomeruli judged as adequate for scoring by the reporting pathologist., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0019], code=at0019, itemType=ELEMENT, level=2, text=Glomeruli solely with necrosis, description=The number of glomeruli showing fibrinoid necrosis without crescent formation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0020], code=at0020, itemType=ELEMENT, level=2, text=Glomeruli with crescents, description=The number of glomeruli showing cellular or fibrocellular crescents., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0021], code=at0021, itemType=ELEMENT, level=2, text=Glomeruli with ischemic changes, description=The number of glomeruli showing some degree of tuft retraction and wrinkling of capillary walls. Chronic ischemic changes might show fibrosis of Bowman's capsule., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0208], code=at0208, itemType=ELEMENT, level=2, text=Glomeruli with adhesions, description=The number of glomeruli showing coneective tissue connections between the tuft and Bowman's capsule without overt sclerosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Glomeruli with segmental sclerosis, description=The number of glomeruli showing obliteration of capillary lumen by extracellular matrix in a portion of the tuft area with or without adhesions to the Bowman capsule, hyaline lesions, foam cells., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0023], code=at0023, itemType=ELEMENT, level=2, text=Glomeruli with global sclerosis, description=The number of glomeruli showing scarring with obliteration of capillary lumen by extracellular matrix in the entire or nearly entire glomerular tuft. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0024], code=at0024, itemType=ELEMENT, level=2, text=Normal glomeruli, description=The number of glomeruli which appear normal without major changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115], code=at0115, itemType=CLUSTER, level=2, text=Mesangium, description=Description of mesangial changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0116], code=at0116, itemType=ELEMENT, level=3, text=No abnormality detected, description=Statement that no abnormality was detected on examination of the mesangial areas., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0118], code=at0118, itemType=ELEMENT, level=3, text=Details of the mesangium, description=A narrative description of mesangial changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0119], code=at0119, itemType=ELEMENT, level=3, text=Mesangial matrix increase, description=Visual assessment of the amount of mesangial matrix., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Mesangial matrix is not increased.]
    • Slight [Mesangial matrix is slightly increased.]
    • Moderate [Mesangial matrix is moderately increased.]
    • Severe [Mesangial matrix is severely increased.]
    • Equivocal [It is uncertain, whether mesangial matrix is increased.]
    • Indeterminate [Mesangial matrix increase could not be assessed. e.g. due to bad morphology.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0128], code=at0128, itemType=ELEMENT, level=3, text=Mesangial hypercellularity, description=A visual assessment of the cellularity of the mesangium. Normally there are 1 - 3 cells per mesangial area. The score is based on the most cellular mesangial area. Mesangial areas adjacent to the vascular stalk should not be scored., comment=Definitions based on Roberts et al, 2009., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [There is no increase in mesangial cells.]
    • Slight [There is a slight increase in mesangial cellularity, usually 4-5 cells per mesangial area.]
    • Moderate [There is a moderate increase in mesangial cellularity, usually 6-7 cells per mesangial area.]
    • Severe [There is a severe increase in mesangial cellularity, usually 8 or more cells per mesangial area.]
    • Equivocal [It is uncertain whether there is an increase in mesangial cellularity or not.]
    • Indeterminate [Mesangial cellularity could not be assessed, e.g. due to bad morphology or thick sections.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0193], code=at0193, itemType=ELEMENT, level=3, text=Mesangial nodularity, description=A visual assessment of the presence of acellular PAS positive mesangial nodules., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Mesangial nodules are absent.]
    • Present [Mesangial nodules are present.]
    • Equivocal [It is uncertain whether mesangial nodules are present.]
    • Indeterminate [Presence of mesangial nodules could not be assessed, e.g. because of bad sections.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138], code=at0138, itemType=CLUSTER, level=2, text=Capillaries, description=Description of glomerular capillary changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0139], code=at0139, itemType=ELEMENT, level=3, text=No abnormality detected, description=Statement that no abnormality was detected on examination of the glomerular capillaries., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0142], code=at0142, itemType=ELEMENT, level=3, text=Details of glomerular capillaries, description=A narrative description of glomerular capillary changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0140], code=at0140, itemType=ELEMENT, level=3, text=Capillary wall thickening, description=A visual assessment of the capillary wall thickness., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Glomerular capillary walls are not thickened.]
    • Focal [Glomerular capillary walls are focally thickened.]
    • Diffuse [Glomerular capillary walls are diffusely thickened.]
    • Segmental [Glomerular capillary walls are segmentally thickened.]
    • Global [Glomerular capillary walls are globally thickened.]
    • Equivocal [It is uncertain whether glomerular capillary walls are thickened.]
    • Indeterminate [Glomerular capillary wall thickness could not be assessed, e.g. due to section thickness.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0150], code=at0150, itemType=ELEMENT, level=3, text=Capillary wall duplication, description=A visual assessment of the presence of capillary wall duplication., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Boolean
  •  Coded Text
    • Absent [Capillary wall duplication is not present.]
    • Focal [Capillary wall duplication is focally present.]
    • Diffuse [Capillary wall duplication is diffusely present.]
    • Segmental [Capillary wall duplication is segmentally present.]
    • Global [Capillary wall duplication is globally present.]
    • Equivocal [It is unceratin whether capillary wall duplication is present.]
    • Indeterminate [Capillary wall thickening could not be assessed, e.g. due to bad morphology.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0188], code=at0188, itemType=ELEMENT, level=3, text=Mesangial cell interposition, description=A visual assesment of the presence of interposed cells in the capillary periphery., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Text
  •  Coded Text
    • Present [Mesangial interposition is present.]
    • Absent [Mesangial interposition is absent.]
    • Equivocal [It is uncertain whether mesangial interposition is present.]
    • Indeterminate [Mesangial interposition could not be assessed, e.g. because of bad sections.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159], code=at0159, itemType=CLUSTER, level=3, text=Capillary lumen, description=Description of changes in the capillary lumens., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0184], code=at0184, itemType=CLUSTER, level=4, text=Thrombi, description=Findings related to intracapillary thrombi., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0184]/items[at0168], code=at0168, itemType=ELEMENT, level=5, text=Thrombi, description=Visual assessment of intracapillary thrombi., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Intracapillary thrombi are absent.]
    • Focal [Intracapillary thrombi are present in less than half of the glomeruli.]
    • Diffuse [Intracapillary thrombi are present in more than half of the glomeruli.]
    • Segmental [Intracapillary thrombi are present only in a part of the glomerular tuft.]
    • Global [Intracapillary thrombi are present in the whole glomerular tuft.]
    • Equivocal [It is uncertain whether intracapillary thrombi are present or not.]
    • Indeterminate [Presence of intracapillary thrombi could not be assessed, e.g. because of bad sections.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0184]/items[at0185], code=at0185, itemType=ELEMENT, level=5, text=Thrombus type, description=Type of intracapillary thrombi., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Hyalin [The intracapillary thrombi are mainly hyalinous.]
  • Fibrin [The intracapillary thrombi consist mainly of fibrin.]
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  •  Coded Text
    • Absent [Endocapillary hypercellularity is not present.]
    • Focal [Endocapillary hypercellularity is focally present.]
    • Diffuse [Endocapillary hypercellularity is diffusely present.]
    • Segmental [Endocapillary hypercellularity is segmentally present.]
    • Global [Endocapillary hypercellularity is globally present.]
    • Equivocal [It is uncertain whether there is endocapillary hypercellularity.]
    • Indeterminate [Endocapillary cellularity could not be assessed, e.g. due to bad morphology.]
  •  Boolean
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  •  Coded Text
    • Endothelial cells [Endothelial cells are part of the intracapillary infiltrate.]
    • Macrophages [Macrophages are part of the intracapillary infiltrate.]
    • Neutrophil granulocytes [Neutrophil granulocytes are part of the intracapillary infiltrate.]
    • Lymphocytes [Lymphocytes are part of the intracapillary infiltrate.]
    • Atypical cells [Atypical cells are part of the intracapillary infiltrate.]
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  •  Coded Text
    • Absent [Podocyte size is normal.]
    • Slight [Podocytes are slightly enlarged.]
    • Moderate [Podocytes are moderately enlarged.]
    • Severe [Podocytes are severely enlarged.]
    • Equivocal [It is uncertain whether podocyte size is normal or enlarged.]
    • Indeterminate [Podocyte size could not be assessed, e.g. due to bad morphology.]
  •  Text
  •  Boolean
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  • Absent [Bi- or multinucleated podocytes are not seen.]
  • Present [Bi- or multinucleated podocytes are seen.]
  • Equivocal [Presence of bi- or mulitnucleated podocytes is equivocal.]
  • Indeterminate [Presence of bi- or mulitnucleated podocytes has not been determined.]

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  • Absent [Podocytes with resorption droplets are not present.]
  • Singular cells [One or few podocytes with resorption droplets are present.]
  • Numerous cells [Numerous podocytes with resorption droplets are present.]
  • Equivocal [It is uncertain whether podocytes with resorption droplets are present or not.]
  • Indeterminate [Presence of podocytes with resorption droplets could not be assessed, e.g. due tof bad morphology.]
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  • Absent [Podocytes with resorption droplets are not present.]
  • Singular [One of few podocytes with resorption droplets are present.]
  • Numerous [Numerous podocytes with resorption droplets are present.]
  • Equivocal [It is uncertain whether podocytes with resorption droplets are present or not.]
  • Indeterminate [Presence of podocytes with resorption droplets could not be assessed, e.g. due to bad morphology.]
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  • Hyaline droplet change [PAS positive absorption droplets in the epithelium of proximal tubules, usually indicating glomerular proteinuria.]
  • Fine vacuolization [Fine, even vacuolization of the proximal tubular epithelium. Hydropic change is a synonym. If related to infusion of hypertonic solutions, the change is also described as osmotic nephrosis. If related to cyclosporin therapy, the change is called isometric vacuolization.]
  • Coarse vacuolization [Irregular and coarse vacuolization of the tubular epithelium. The change might be associated with hypokaliemia or tubulotoxicity.]
  • Fatty change [Fine vacuoles containing lipid, often at the base of the tubular epithelial cells. Fat can be demonstrated by lipid stains on frozen sections.]
  • Giant mitochondria [Enlarged mitochondria visuable as eosinophilic bodies in tubular epithelial cells.]
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  • Tamm Horsfall protein [Presence of intratubular Tamm Horsfall protein.]
  • Hyaline casts [Presence of hyalin casts in tubular lumen.]
  • Granular casts [Presence of granular casts in tubular lumen.]
  • Detached cells [Detached cells, commonly epithelial cells, present in the tubular lumen.]
  • Red blood cells [Collections of red blood cells or red blood cell casts present in tubular lumen.]
  • Granulocytes [Presence of neutrophil granulocytes in tubular lumen.]
  • Mixed casts [Casts consisting of more than one component.]
  • Pigmented casts [Discolorated casts e.g. due to hemoglobin, myoglobin, drug pigments, bilirubin, melanin.]
  • Myeloma casts [Characteristic myeloma casts, often surrounded by reactive tubular epithelial cells. or multinucleated cells, present in tubular lumen.]
  • Crystals [Crystals present in tubular lumen.]
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  • Absent [Tubular atrophy is not present or minimal (few transsections).]
  • Slight [Tubular atrophy in up to 25 % of the area of cortical tubules.]
  • Moderate [Tubular atrophy involving 25 - 50% of the area of cortical tubules.]
  • Severe [Tubular atrophy present in more than 50% of the area of cortical tubules.]
  • Indeterminate [Tubular atrophy could not be assessed, e.g. due to bad sections.]
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  •  Coded Text
    • Sirius red unpolarized [Sirius red stain unpolarized used for fibrosis quantification by image analysis]
    • Sirius red polarized [Sirius red stain polarized used for fibrosis quantification by image analysis]
    • Collagen III immunohistochemistry [Collagen III immunohistochemical stain used for fibrosis quantification by image analysis]
  •  Text
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Units: %, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0049]/items[at0050]/items[at0079], code=at0079, itemType=ELEMENT, level=3, text=Multimedia representation of image analysis, description=Images, graphs and tables from automatic image analysis of interstitial fibrosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0049]/items[at0057], code=at0057, itemType=ELEMENT, level=2, text=Cortical area with fibrosis estimated, description=Visual quantification of interstitial fibrosis; The fibrosis percentage is the percentage of abnormal cortical tissue with fibrosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Proportion
Units: <=0.0 %
Limit decimal places: 0, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0049]/items[at0058], code=at0058, itemType=ELEMENT, level=2, text=Fibrous tissue estimated, description=Visual quantification of interstitial fibrosis; The fibrosis percentage is the percentage of all cortical tissue (excluding tubules and glomeruli) occupied by fibrous tissue., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Proportion
Units: %
Limit decimal places: 0, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0049]/items[at0059], code=at0059, itemType=ELEMENT, level=2, text=Interstitium description, description=Description of interstitial changes, e.g. edema, inflammatory cells, deposits., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0060], code=at0060, itemType=CLUSTER, level=1, text=Vasculature, description=Changes affecting arteries, arterioles, venes and peritubular capillaries., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0060]/items[at0211], code=at0211, itemType=ELEMENT, level=2, text=No abnormality detected, description=A statement that no abnormality was detected in the renal vasculature., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0060]/items[at0061], code=at0061, itemType=ELEMENT, level=2, text=Number of arteries, description=Number of arteries in a renal biopsy., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0060]/items[at0062], code=at0062, itemType=ELEMENT, level=2, text=Arteriosclerosis, description=Amount of arteriosclerosis in the most affected vessel., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Not present/minimal [There is no intimal sclerosis or intimal sclerosis is minimal.]
    • Mild [There is < 25% lumen narrowing by intimal fibrosis.]
    • Moderate [There is 25% - 50% lumen narrowing by intimal fibrosis.]
    • Severe [There is > 50% lumen narrowing by intimal fibrosis.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0060]/items[at0067], code=at0067, itemType=ELEMENT, level=2, text=Arteriolosclerosis, description=Amount of arteriolosclerosis in the most affected vessel., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Text
  •  Coded Text
    • Absent [Arteriolosclerosis not present.]
    • Present - nodular [Nodular arteriolosclerosis is present.]
    • Present - circumferential [Circumferential arteriolosclerosis is present.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0060]/items[at0071], code=at0071, itemType=ELEMENT, level=2, text=Vasculature description, description=Description of vascular changes, e.g. vasculitis, venulitis. For description of severity of arteriosclerosis and arteriolosclerosis use coded text., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0072], code=at0072, itemType=CLUSTER, level=1, text=Amyloid, description=Findings related to amyloid deposition., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0072]/items[at0212], code=at0212, itemType=ELEMENT, level=2, text=Amyloid not detected, description=A statement that no amyloid deposition was detected., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0072]/items[at0076], code=at0076, itemType=SLOT, level=2, text=Details of amyloid deposition , description=Slot for detailed description of specific glomerular changes. Include: openEHR-EHR-CLUSTER.amyloid_deposition.v1, comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0077], code=at0077, itemType=SLOT, level=1, text=Specific clinical situations, description=Detailed structured description for specific clinical situations, e.g. biopsy of renal transplant, lupus nephritis, IgA nephropathy., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0078], code=at0078, itemType=ELEMENT, level=1, text=Multimedia representation, description=Images from lesions could be attached here., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=, extendedValues=null]], description=[], protocol=[], ism_transition=[], context=[], data=[], activities=[], relationships=[], credentials=[], target=[], source=[], state=[], content=[], contacts=[], capabilities=[]}, topLevelItems={items=ResourceSimplifiedHierarchyItem [path=ROOT_/, code=at0000, itemType=CLUSTER, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=items, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/items[at0001], code=at0001, itemType=CLUSTER, level=1, text=Renal biopsy overall description, description=Describes tissue types in the renal biopsy specimen., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0003], code=at0003, itemType=ELEMENT, level=2, text=Cortex, description=Cortical tissue present, alternatively core length with cortical tissue, alternatively proportion of cortical tissue in relation to the core with renal tissue., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Present [Cortical tissue present.]
    • Absent [Cortical tissue absent.]
    • Indeterminate [Presence of cortical tissue has not been determined.]
  •  Quantity
    Property: Length
    Units: mm
  •  Proportion
    • Percent
    Integral
    Assumed value: false
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0007], code=at0007, itemType=ELEMENT, level=2, text=Medulla, description=Medullary tissue present, alternatively core length with medullary tissue, alternatively proportion of medullary tissue in relation to the core with renal tissue., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Present [Medullary tissue present.]
    • Absent [Medullary tissue absent.]
    • Indeterminate [Presence of medullary tissue has not been determined.]
  •  Quantity
    Property: Length
    Units: mm
  •  Proportion
    • Percent
    Integral
    Assumed value: false
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0011], code=at0011, itemType=ELEMENT, level=2, text=Renale capsule, description=A statement whether the renal capsule is present., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0001]/items[at0012], code=at0012, itemType=ELEMENT, level=2, text=Other tissue elements, description=Description of other tissue elements, e.g. muscle tissue., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Sceletal muscle and/or fat tissue and/or connective tissue [Sceletal muscle and/or fat tissue and/or connective tissue present.]
    • Renal pelvis mucosa [Renal pelvis mucosa present.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015], code=at0015, itemType=CLUSTER, level=1, text=Glomeruli, description=Description of glomerular changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0016], code=at0016, itemType=ELEMENT, level=2, text=Glomeruli, description=The maximum number of glomeruli irrespective of size present in one section; structures consisting of Bowman's capsule with empty Bowman's space are excluded., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0017], code=at0017, itemType=ELEMENT, level=2, text=Scorable glomeruli, description=The number of glomeruli judged as adequate for scoring by the reporting pathologist., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0019], code=at0019, itemType=ELEMENT, level=2, text=Glomeruli solely with necrosis, description=The number of glomeruli showing fibrinoid necrosis without crescent formation., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0020], code=at0020, itemType=ELEMENT, level=2, text=Glomeruli with crescents, description=The number of glomeruli showing cellular or fibrocellular crescents., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0021], code=at0021, itemType=ELEMENT, level=2, text=Glomeruli with ischemic changes, description=The number of glomeruli showing some degree of tuft retraction and wrinkling of capillary walls. Chronic ischemic changes might show fibrosis of Bowman's capsule., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0208], code=at0208, itemType=ELEMENT, level=2, text=Glomeruli with adhesions, description=The number of glomeruli showing coneective tissue connections between the tuft and Bowman's capsule without overt sclerosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0022], code=at0022, itemType=ELEMENT, level=2, text=Glomeruli with segmental sclerosis, description=The number of glomeruli showing obliteration of capillary lumen by extracellular matrix in a portion of the tuft area with or without adhesions to the Bowman capsule, hyaline lesions, foam cells., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0023], code=at0023, itemType=ELEMENT, level=2, text=Glomeruli with global sclerosis, description=The number of glomeruli showing scarring with obliteration of capillary lumen by extracellular matrix in the entire or nearly entire glomerular tuft. , comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0024], code=at0024, itemType=ELEMENT, level=2, text=Normal glomeruli, description=The number of glomeruli which appear normal without major changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115], code=at0115, itemType=CLUSTER, level=2, text=Mesangium, description=Description of mesangial changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0116], code=at0116, itemType=ELEMENT, level=3, text=No abnormality detected, description=Statement that no abnormality was detected on examination of the mesangial areas., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0118], code=at0118, itemType=ELEMENT, level=3, text=Details of the mesangium, description=A narrative description of mesangial changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0119], code=at0119, itemType=ELEMENT, level=3, text=Mesangial matrix increase, description=Visual assessment of the amount of mesangial matrix., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Mesangial matrix is not increased.]
    • Slight [Mesangial matrix is slightly increased.]
    • Moderate [Mesangial matrix is moderately increased.]
    • Severe [Mesangial matrix is severely increased.]
    • Equivocal [It is uncertain, whether mesangial matrix is increased.]
    • Indeterminate [Mesangial matrix increase could not be assessed. e.g. due to bad morphology.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0128], code=at0128, itemType=ELEMENT, level=3, text=Mesangial hypercellularity, description=A visual assessment of the cellularity of the mesangium. Normally there are 1 - 3 cells per mesangial area. The score is based on the most cellular mesangial area. Mesangial areas adjacent to the vascular stalk should not be scored., comment=Definitions based on Roberts et al, 2009., uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [There is no increase in mesangial cells.]
    • Slight [There is a slight increase in mesangial cellularity, usually 4-5 cells per mesangial area.]
    • Moderate [There is a moderate increase in mesangial cellularity, usually 6-7 cells per mesangial area.]
    • Severe [There is a severe increase in mesangial cellularity, usually 8 or more cells per mesangial area.]
    • Equivocal [It is uncertain whether there is an increase in mesangial cellularity or not.]
    • Indeterminate [Mesangial cellularity could not be assessed, e.g. due to bad morphology or thick sections.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0115]/items[at0193], code=at0193, itemType=ELEMENT, level=3, text=Mesangial nodularity, description=A visual assessment of the presence of acellular PAS positive mesangial nodules., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Mesangial nodules are absent.]
    • Present [Mesangial nodules are present.]
    • Equivocal [It is uncertain whether mesangial nodules are present.]
    • Indeterminate [Presence of mesangial nodules could not be assessed, e.g. because of bad sections.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138], code=at0138, itemType=CLUSTER, level=2, text=Capillaries, description=Description of glomerular capillary changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0139], code=at0139, itemType=ELEMENT, level=3, text=No abnormality detected, description=Statement that no abnormality was detected on examination of the glomerular capillaries., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0142], code=at0142, itemType=ELEMENT, level=3, text=Details of glomerular capillaries, description=A narrative description of glomerular capillary changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0140], code=at0140, itemType=ELEMENT, level=3, text=Capillary wall thickening, description=A visual assessment of the capillary wall thickness., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Glomerular capillary walls are not thickened.]
    • Focal [Glomerular capillary walls are focally thickened.]
    • Diffuse [Glomerular capillary walls are diffusely thickened.]
    • Segmental [Glomerular capillary walls are segmentally thickened.]
    • Global [Glomerular capillary walls are globally thickened.]
    • Equivocal [It is uncertain whether glomerular capillary walls are thickened.]
    • Indeterminate [Glomerular capillary wall thickness could not be assessed, e.g. due to section thickness.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0150], code=at0150, itemType=ELEMENT, level=3, text=Capillary wall duplication, description=A visual assessment of the presence of capillary wall duplication., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Boolean
  •  Coded Text
    • Absent [Capillary wall duplication is not present.]
    • Focal [Capillary wall duplication is focally present.]
    • Diffuse [Capillary wall duplication is diffusely present.]
    • Segmental [Capillary wall duplication is segmentally present.]
    • Global [Capillary wall duplication is globally present.]
    • Equivocal [It is unceratin whether capillary wall duplication is present.]
    • Indeterminate [Capillary wall thickening could not be assessed, e.g. due to bad morphology.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0188], code=at0188, itemType=ELEMENT, level=3, text=Mesangial cell interposition, description=A visual assesment of the presence of interposed cells in the capillary periphery., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Text
  •  Coded Text
    • Present [Mesangial interposition is present.]
    • Absent [Mesangial interposition is absent.]
    • Equivocal [It is uncertain whether mesangial interposition is present.]
    • Indeterminate [Mesangial interposition could not be assessed, e.g. because of bad sections.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159], code=at0159, itemType=CLUSTER, level=3, text=Capillary lumen, description=Description of changes in the capillary lumens., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0184], code=at0184, itemType=CLUSTER, level=4, text=Thrombi, description=Findings related to intracapillary thrombi., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0184]/items[at0168], code=at0168, itemType=ELEMENT, level=5, text=Thrombi, description=Visual assessment of intracapillary thrombi., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Intracapillary thrombi are absent.]
    • Focal [Intracapillary thrombi are present in less than half of the glomeruli.]
    • Diffuse [Intracapillary thrombi are present in more than half of the glomeruli.]
    • Segmental [Intracapillary thrombi are present only in a part of the glomerular tuft.]
    • Global [Intracapillary thrombi are present in the whole glomerular tuft.]
    • Equivocal [It is uncertain whether intracapillary thrombi are present or not.]
    • Indeterminate [Presence of intracapillary thrombi could not be assessed, e.g. because of bad sections.]
  •  Text
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0184]/items[at0185], code=at0185, itemType=ELEMENT, level=5, text=Thrombus type, description=Type of intracapillary thrombi., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_CODED_TEXT, bindings=null, values=
  • Hyalin [The intracapillary thrombi are mainly hyalinous.]
  • Fibrin [The intracapillary thrombi consist mainly of fibrin.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0170], code=at0170, itemType=CLUSTER, level=4, text=Endocapillary hypercellularity, description=Findings related to endocapillary cellularity., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0170]/items[at0160], code=at0160, itemType=ELEMENT, level=5, text=Endocapillary hypercellularity, description=Visual assessment of endocapillary hypercellularity., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Endocapillary hypercellularity is not present.]
    • Focal [Endocapillary hypercellularity is focally present.]
    • Diffuse [Endocapillary hypercellularity is diffusely present.]
    • Segmental [Endocapillary hypercellularity is segmentally present.]
    • Global [Endocapillary hypercellularity is globally present.]
    • Equivocal [It is uncertain whether there is endocapillary hypercellularity.]
    • Indeterminate [Endocapillary cellularity could not be assessed, e.g. due to bad morphology.]
  •  Boolean
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0138]/items[at0159]/items[at0170]/items[at0171], code=at0171, itemType=ELEMENT, level=5, text=Cell type, description=Composition of intracapillary cells., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Text
  •  Coded Text
    • Endothelial cells [Endothelial cells are part of the intracapillary infiltrate.]
    • Macrophages [Macrophages are part of the intracapillary infiltrate.]
    • Neutrophil granulocytes [Neutrophil granulocytes are part of the intracapillary infiltrate.]
    • Lymphocytes [Lymphocytes are part of the intracapillary infiltrate.]
    • Atypical cells [Atypical cells are part of the intracapillary infiltrate.]
, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0088], code=at0088, itemType=CLUSTER, level=2, text=Podocytes, description=Description of podocyte changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=1..*, cardinalityText=, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0088]/items[at0117], code=at0117, itemType=ELEMENT, level=3, text=No abnormality detected, description=Statement that no abnormality was detected on examination of podocytes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_BOOLEAN, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0088]/items[at0125], code=at0125, itemType=ELEMENT, level=3, text=Details of podocytes, description=A narrative description of podocyte changes., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_TEXT, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0015]/items[at0088]/items[at0089], code=at0089, itemType=ELEMENT, level=3, text=Hypertrophy, description=Enlarged podocytes often with amphophil cytoplasm., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CHOICE, bindings=null, values=Choice of:
  •  Coded Text
    • Absent [Podocyte size is normal.]
    • Slight [Podocytes are slightly enlarged.]
    • Moderate [Podocytes are moderately enlarged.]
    • Severe [Podocytes are severely enlarged.]
    • Equivocal [It is uncertain whether podocyte size is normal or enlarged.]
    • Indeterminate [Podocyte size could not be assessed, e.g. due to bad morphology.]
  •  Text
  •  Boolean
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  • Absent [Bi- or multinucleated podocytes are not seen.]
  • Present [Bi- or multinucleated podocytes are seen.]
  • Equivocal [Presence of bi- or mulitnucleated podocytes is equivocal.]
  • Indeterminate [Presence of bi- or mulitnucleated podocytes has not been determined.]

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  • Absent [Podocytes with resorption droplets are not present.]
  • Singular cells [One or few podocytes with resorption droplets are present.]
  • Numerous cells [Numerous podocytes with resorption droplets are present.]
  • Equivocal [It is uncertain whether podocytes with resorption droplets are present or not.]
  • Indeterminate [Presence of podocytes with resorption droplets could not be assessed, e.g. due tof bad morphology.]
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  • Absent [Podocytes with resorption droplets are not present.]
  • Singular [One of few podocytes with resorption droplets are present.]
  • Numerous [Numerous podocytes with resorption droplets are present.]
  • Equivocal [It is uncertain whether podocytes with resorption droplets are present or not.]
  • Indeterminate [Presence of podocytes with resorption droplets could not be assessed, e.g. due to bad morphology.]
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  • Hyaline droplet change [PAS positive absorption droplets in the epithelium of proximal tubules, usually indicating glomerular proteinuria.]
  • Fine vacuolization [Fine, even vacuolization of the proximal tubular epithelium. Hydropic change is a synonym. If related to infusion of hypertonic solutions, the change is also described as osmotic nephrosis. If related to cyclosporin therapy, the change is called isometric vacuolization.]
  • Coarse vacuolization [Irregular and coarse vacuolization of the tubular epithelium. The change might be associated with hypokaliemia or tubulotoxicity.]
  • Fatty change [Fine vacuoles containing lipid, often at the base of the tubular epithelial cells. Fat can be demonstrated by lipid stains on frozen sections.]
  • Giant mitochondria [Enlarged mitochondria visuable as eosinophilic bodies in tubular epithelial cells.]
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  • Tamm Horsfall protein [Presence of intratubular Tamm Horsfall protein.]
  • Hyaline casts [Presence of hyalin casts in tubular lumen.]
  • Granular casts [Presence of granular casts in tubular lumen.]
  • Detached cells [Detached cells, commonly epithelial cells, present in the tubular lumen.]
  • Red blood cells [Collections of red blood cells or red blood cell casts present in tubular lumen.]
  • Granulocytes [Presence of neutrophil granulocytes in tubular lumen.]
  • Mixed casts [Casts consisting of more than one component.]
  • Pigmented casts [Discolorated casts e.g. due to hemoglobin, myoglobin, drug pigments, bilirubin, melanin.]
  • Myeloma casts [Characteristic myeloma casts, often surrounded by reactive tubular epithelial cells. or multinucleated cells, present in tubular lumen.]
  • Crystals [Crystals present in tubular lumen.]
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  • Absent [Tubular atrophy is not present or minimal (few transsections).]
  • Slight [Tubular atrophy in up to 25 % of the area of cortical tubules.]
  • Moderate [Tubular atrophy involving 25 - 50% of the area of cortical tubules.]
  • Severe [Tubular atrophy present in more than 50% of the area of cortical tubules.]
  • Indeterminate [Tubular atrophy could not be assessed, e.g. due to bad sections.]
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  •  Coded Text
    • Sirius red unpolarized [Sirius red stain unpolarized used for fibrosis quantification by image analysis]
    • Sirius red polarized [Sirius red stain polarized used for fibrosis quantification by image analysis]
    • Collagen III immunohistochemistry [Collagen III immunohistochemical stain used for fibrosis quantification by image analysis]
  •  Text
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Units: %, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0049]/items[at0050]/items[at0079], code=at0079, itemType=ELEMENT, level=3, text=Multimedia representation of image analysis, description=Images, graphs and tables from automatic image analysis of interstitial fibrosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0049]/items[at0057], code=at0057, itemType=ELEMENT, level=2, text=Cortical area with fibrosis estimated, description=Visual quantification of interstitial fibrosis; The fibrosis percentage is the percentage of abnormal cortical tissue with fibrosis., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_QUANTITY, bindings=null, values=Property: Proportion
Units: <=0.0 %
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Units: %
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  •  Coded Text
    • Not present/minimal [There is no intimal sclerosis or intimal sclerosis is minimal.]
    • Mild [There is < 25% lumen narrowing by intimal fibrosis.]
    • Moderate [There is 25% - 50% lumen narrowing by intimal fibrosis.]
    • Severe [There is > 50% lumen narrowing by intimal fibrosis.]
  •  Text
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  •  Text
  •  Coded Text
    • Absent [Arteriolosclerosis not present.]
    • Present - nodular [Nodular arteriolosclerosis is present.]
    • Present - circumferential [Circumferential arteriolosclerosis is present.]
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All not explicitly excluded archetypes, extendedValues=null], ResourceSimplifiedHierarchyItem [path=/items[at0078], code=at0078, itemType=ELEMENT, level=1, text=Multimedia representation, description=Images from lesions could be attached here., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_MULTIMEDIA, bindings=null, values=, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]