Laura Barisoni, MD, a Duke Pathology Professor, is the leading pathologist for the Nephrotic Syndrome study Network (NEPTUNE) and principal investigator of a study sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). It aims to study and reframe the classification of proteinuric diseases like Focal Segmental Glomerulosclerosis (FSGS) and Minimal Change Disease (MCD). In a recently published study in the American Journal of Kidney Diseases and featured in the “ASN in the loop”, an interdisciplinary team of investigators lead by Dr. Barisoni has applied a novel scoring system (the NEPTUNE Digital Pathology Scoring System) to digital kidney biopsies to capture 37 discrete structural changes in the glomeruli. Using unsupervised cluster analysis allowed for the identification of groups of patients with similar morphologic, clinical and molecular characteristics and the identification of 6 morphologic parameters as biomarkers of outcomes and gene expression. This work represents a step forward to better reclassify patients with a conventional diagnosis of FSGS and MCD into clinically and molecularly relevant categories and use renal biopsy tissue interrogation to identify morphologic surrogate biomarkers of mechanism for improved targeted intervention. Read the study.