engleski

Renal biopsy registry from Croatian university hospital : a 15 years of experience with review of epidemiological data

Introduction and Aims: Renal biopsy registries are valuable pool of clinical, laboratory and histological data for understanding epidemiology of renal disease as well as for clinical research. In this abstract we will present epidemiological data gathered from Renal biopsy registry of our Hospital, where almost two-thirds of all native renal biopsies in adult Croatian patients were done. Methods: Using Microsoft Office Access Database, a relevant demographic, laboratory and histopathological data were collected from 831 adult patients who had undergone kidney biopsy during period of 1997.-2011. Data included gender and age, weight and height, blood pressure, serume creatinine concentration, maximal 24-hour proteinuria level and therapeutical modalities. Indications for renal biopsy were defined as an asymptomatic hematuria and/or proteinuria syndrome, acute or chronic nephritic syndrome, acute renal failure of uknown etiology, nephrotic syndrome, revision of previous biopsy and suspected inherited renal disorder. Tissue samples for histopathological analysis were obtained by ultrasound-guided percutaneous renal biopsy performed in local anesthesia using 16-gauge core- needle (automatic biopsy device Biopty Bard, USA). All samples were analyzed by light, immunofluorescence and electron microscopy. Results: From 831 analyzed patients, 470 (56.6%) were male and 361 (43.4%) female, aged between 16 and 80 years (mean 47.2 years). The most frequent indication for renal biopsy was nephrotic syndrome founded in 335 (40%) patients, followed by asymptomatic hematuria and/or proteinuria syndrome in 240 (29%) patients, chronic nephritic syndrome in 106 (13%) patients, acute nephritic syndrome and acute renal failure of unknown etiology, each in 50 (6%) patients. The revision of previous biopsy (rebiopsy) was done in 40 (5%) cases. The primary glomerulonephritis was found in 52% of patients, secondary type of glomerular disorders in 25%, hereditary disorders in 6%, tubulointerstitial diseases in 5% and end stage kidney disease in 1% of patients. The most common primary glomerulonephritis was IgA nephropathy diagnosed in 19% of all patients, followed by focal segmental glomerulosclerosis (17% of all patients) and membranous nephropathy (9% of all patients). Among secondary glomerular disorders, pauci-immune cresentic glomerulonephritis and lupus nephritis (both in 7% of all patients) were most observed, followed by diabetic nephropathy (4.2% of all patients) and plasma cell dyscrasias (2.7% of all patients). The chronic interstitial nephritis was the most common of the tubulointerstitial nephropathies. Acute postinfectious glomerulonephritis and hypertension nephropathy were found each in 1.5% of patients. Male gender was predominant in most diagnosed entities, except in minimal change disease, lupus nephritis and thin basement membrane disease. Conclusions: This is the first renal biopsy registry in the Republic of Croatia and should serve to improve understanding of renal disease epidemiology in Croatia and help creating the National registry of renal biopsies.

renal biopsy; registry; epidemiology

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