CLINICOPATHOLOGICAL CORRELATION IN CHRONIC KIDNEY DISEASE: A MULTIDISCIPLINARY REVIEW

Chronic kidney disease (CKD) is a heterogeneous, progressive condition where the measurement of functional aspects
and clinical phenotypes might not be sufficient in evaluating the underlying structural damage. This review synthesizes
evidence on clinicopathological correlation in CKD and evaluates how integrating histopathology with clinical
assessment, laboratory markers, and imaging improves diagnostic precision and prognostic assessment. Key
clinicopathological relationships are highlighted, including how proteinuria and active urinary sediment often signal
glomerular injury, whereas declining renal function frequently aligns with the burden of tubulointerstitial fibrosis and
vascular disease. The review also examines how pathological severity generally increases with advancing CKD stage,
limiting reversibility and narrowing therapeutic windows. Importantly, discordance between presumed clinical diagnoses
and biopsy findings is common in systemic and comorbidity-driven CKD, underscoring the value of tissue-based
evaluation in selected cases. A multidisciplinary framework involving nephrology, pathology, radiology, and laboratory
medicine is emphasized as essential for integrated interpretation and individualized care. Emerging biomarkers, advanced
imaging approaches, and risk prediction models are discussed as tools that may enhance stratification and support
personalized management, while ongoing challenges include disease heterogeneity, methodological limitations, and
delayed recognition of progressive injury. Clinicopathological integration provides a robust pathway toward more accurate
classification, targeted intervention, and improved outcomes in CKD.