Clinical and Pathological Findings of Renal Biopsy in Children: Outcomes from a Single Center Over 27 Years
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Purpose: To classify the results of renal biopsy in pediatric patients and to compare pathological findings with clinical features. Methods: This study included data of 318 children who underwent renal biopsy at our hospital between December 1987 and November 2014. Biopsy specimens were examined histopathologically using light, immunofluorescence, and electron microscopy. Results: Asymptomatic urinary abnormalities was the most common clinical diagnosis (35.9%), followed by nephrotic syndrome (29.3%), and acute glomerulonephritis (18.0%). Glomerular disease was identified in 98.1% of the renal biopsy specimens. The most common primary cause of glomerulonephritis was IgA nephropathy, with gross hematuria in 61.9% of the patients, hypertension in 14.2%, proteinuria >1.0 gm/24-hr in 33.3%, and impaired renal function in 3.6% patients. Conclusion: The most common clinical diagnosis was asymptomatic urinary abnormalities, with primary glomerular disease being the most common renal biopsy finding, and IgA nephropathy the most common histopathological lesion. This study provides a 27-year overview of pediatric renal disease at our center and underlines the importance of renal biopsy for accurate diagnosis and proper management.
Abstract
Purpose: To classify the results of renal biopsy in pediatric patients and to compare pathological findings with clinical features. Methods: This study included data of 318 children who underwent renal biopsy at our hospital between December 1987 and November 2014. Biopsy specimens were examined histopathologically using light, immunofluorescence, and electron microscopy. Results: Asymptomatic urinary abnormalities was the most common clinical diagnosis (35.9%), followed by nephrotic syndrome (29.3%), and acute glomerulonephritis (18.0%). Glomerular disease was identified in 98.1% of the renal biopsy specimens. The most common primary cause of glomerulonephritis was IgA nephropathy, with gross hematuria in 61.9% of the patients, hypertension in 14.2%, proteinuria >1.0 gm/24-hr in 33.3%, and impaired renal function in 3.6% patients. Conclusion: The most common clinical diagnosis was asymptomatic urinary abnormalities, with primary glomerular disease being the most common renal biopsy finding, and IgA nephropathy the most common histopathological lesion. This study provides a 27-year overview of pediatric renal disease at our center and underlines the importance of renal biopsy for accurate diagnosis and proper management.
참고문헌 (29)
- Tondel C, "Safety and complications of percutaneous kidney biopsies in 715 children and 8573 adults in Norway 1988-2010", Clin J Am Soc Nephrol, 7, pp.1591~1597 (2012)
- Gault MH, "Renal biopsy: Current views and controversies", Nephron, 34, pp.1~34 (1983)
- Edelmann CM Jr, "A modified technique for percutaneous needle biopsy of the kidney", J Pediatr, 70, pp.81~86 (1967)
- al Rasheed SA, "The outcome of percutaneous renal biopsy in children: An analysis of 120 consecutive cases", Pediatr Nephrol, 4, pp.600~603 (1990)
- Fuiano G, "Current indication for renal biopsy: A questionnaire based survey", Am J Kidney Dis, 35, pp.448~457 (2000)
- Haas M, "Histologic subclassification of IgA nephropathy: A clinicopathologic study of 244 cases", Am J Kidney Dis, 28, pp.829~842 (1997)
- Cameron JS, "The introduction of renal biopsy into nephrology from 1901 to 1961; A paradigm of the forming of nephrology by technology", Am J Nephrol, 17, pp.348~358 (1997)
- Habib R, "A story of glomerulopathies: A pathologist’s experience", Pediatr Nephrol, 7, pp.336~346 (1993)
- Feneberg R, "Percutaneous renal biopsy in children: a 27-year experience", Nephron, 79, pp.438~446 (1998)
- Kamitsuji H, "Percutaneous renal biopsy in children:survey of pediatric nephrologists in Japan", Pediatr Nephrol, 13, pp.693~696 (1999)
- Choi IJ, "An analysis of 4514 cases of renal biopsy in Korea", Yonsei Med J, 2, pp.247~254 (2001)
- Printza N, "Percutaneous ultrasound-guided renal biopsy in children:a single center experience", Hippokratia, 3, pp.258~261 (2011)
- Lanewala A, "Pattern of pediatric renal disease observed in native renal biopsies in Pakistan", J Nephrol, 22, pp.739~746 (2009)
- Moorani KN, "Histopathological pattern in childhood glomerulonephritis", J Pak Med Assoc, 60, pp.1006~1009 (2010)
- Ali A, "Histological pattern of paediatric renal diseases in northern Pakistan", J Pak Med Assoc, 61, pp.653~658 (2011)
- Absar A, "Ten year experience of pediatric kidney biopsies from a single center in Pakistan", Indian J Nephrol, 20, pp.190~192 (2010)
- 박용훈, "School Urine Screening Program in Korea", Childhood Kidney Diseases, 18(2), pp.57~63 (2014), 대한소아신장학회
- Kim BK, "Clinicopathological study on renal biopsies in children", J Korean Med Assoc, 24, pp.425~432 (1981)
- Border WA, "Distinguishing minimal-change disease from mesangial disorders", Kidney Int, 34(3), pp.419~ (1988)
- Myllymaki J, "IgM nephropathy:clinical picture and long-term prognosis", Am J Kidney Dis, 41, pp.343~350 (2003)
- Al-Eisa A, "Children IgM nephropathy:comparison with minimal change disease", Nephron, 72, pp.37~43 (1996)
- A report of the International Study of Kidney Disease in Children, "Nephrotic syndrome in children: prediction of histopathology from clinical and laboratory characteristics at time of diagnosis", Kidney Int, 13, pp.159~ (1978)
- White RHR, "Clinicopathological study of nephrotic syndrome in childhood", Lancet, 1, pp.1353~1359 (1970)
- Habib R, "The primary nephrotic syndrome of childhood. Classification and clinicopathologic study of 406cases", Pathology annual, 6, pp.417~474 (1971)
- Kitajima T, "Clinicopathological features in the Japanese patients with IgA nephropathy", Jpn J Med, 22, pp.219~222 (1983)
- D'Amico G, "Prognostic indicators in idiopathic IgA mesangical nephropathy", Quarterly J Med, 59, pp.363~378 (1986)
- Topaloglu R, "Clinicopathological and immunohistological features in childhood IgA nephropathy: a single-centre experience", Clin Kidney J, 6, pp.169~175 (2013)
- Haas M, "IgA nephropathy in children and adults comparison of histologic features and clinical outcome", Nephrol Dial Transplant, 23, pp.2537~2545 (2008)
- Fofi C, "IgA nephropathy: multivariate statistical analysis aimed at predicting outcome", J Nephrol, 14, pp.280~285 (2001)