Epidemiological Review of Kidney Biopsy during 30 years - Single Center Experience

Abstract

Abstract Introduction. Renal biopsy represents a diagnostic method that provides an acurrate diagnosis and adequate treatment of different renal diseases. The first biopsy in our Center was done in June 1982, but it has been performing routinely since 1984. The aim of this study was to report the histopathological features of biopsy proven kidney disease during the past 30 years. Methods. During 30 years, a total of 563 biopsies were performed, of which 530(94%) were succesfull. Data about gender, age, clinical syndrome and histopatological finding were collected from the medical records. Results. The mean age of our patients was 48±11 years, 53% were man (No=272). In the first decade (1982-1994) we performed 118(mean age 50±13), in the second (1995- 2004) 208 (mean age 46±14), and in the third decade (2005-2014) 189 renal biopsies (mean age 50±16). Mean number of glomeruli per biopsy was 18±11. There were only two serious complications. The most common clinical syndromes as indication for renal biopsy were: nephrotic proteinuria (41%) followed by asymptomatic urinary abnormalities (AUA-14.8%), chronic renal failure (CRF-13.8%), acute kidney injury (AKI-12.8%), nephritic syndrome (7.6%), systemic lupus erytematosus (SLE- 4.5%), isolated haematuria (2.7% of the cases) and other (2.9%). The major histological groups identified were: primary glomerulonephritis (GN) (62.3%), secondary GN (21.2%), and other (16.5% of the cases). The most common primary glomerulonephritis (PGN) were focal segmental glomerulosclerosis-FSGS (19.4%) followed by IgA nephropathy-IgAN (18.8%), membranous GNMGN (16.4%) and mesangial proliferation-MesGN (16%). Interstitial changes were present in 55% of biopsy samples in the first, in 66% in the second and in 63% in the third decade. Blood vessel changes were present in 39% of biopsy samples in the first, in 62% in the second and in 72% in the third decade. Conclusions. The most frequent finding among PGN was mesangioproliferative GN (including IgAN, alltogether 34.8%) followed by FSGS and MGN. Apart from succesful biopsies, there are several aspects to be improved in the future including expanding indications and earlier procedure during the course of chronic kidney disease-CKD.