An analysis of 4,514 cases of renal biopsy in Korea

Abstract

To evaluate the distribution and changing patterns of renal diseases in Korea, a total of 4,514 cases of renal biopsy collected over a 23-year period between 1973 and 1995 were reviewed. Of 4,200 cases excluding 314 unsatisfactory biopsies, adult cases comprised 59.5% and pediatric cases, 40.5%. The male to female ratio was 1.5:1 in adults and 2.2:1 in children. Glomerulonephritis (GN) comprised 80.0% of the total. The most common primary GN in adults was minimal change disease (MCD) (26.6%), followed by IgA nephropathy (IgAN) (22.1%), membranous GN (MGN) (11.8%), and membranoproliferative GN (MPGN) (5.9%). In children, the primary GN incidence rates were MCD (24.8%), IgAN (10.3%), poststreptococcal (including postinfectious) GN (PSGN) (8.6%), and focal segmental glomerulosclerosis (FSGS) (4.0%). The most common secondary GN in adults was lupus nephritis and in children Henoch-Schonlein purpura nephritis. The most common cause of nephrotic syndrome was MCD in both adults and children, followed by MGN and FSGS. The elderly, aged sixty years and older, comprised 2.7% of cases and recorded equal numbers of MCD and MGN. The proportion of the biopsies found to be seropositive for HBs antigen was 27.9%, and these showed either MGN or MPGN pattern. Repeat biopsy was performed in 168 patients, due to previous biopsy failure in 15.5%. When the primary GN cases were analyzed at 5-year intervals, the prevalence of PSGN, which was greater than 25% during the 1973-1982 period, decreased abruptly in children thereafter, whereas the prevalence of FSGS increased slowly since the 1988-1992 period in both adults and children. The decrease of PSGN and the increase of FSGS suggest a role for socioeconomic and environmental factors in Korea.

Epidemiologic data of adult native biopsy-proven renal diseases in Croatia

“…In patients with NS the most common diagnosis was FSGS (20.2%), followed by MGN (18.8%). In most other studies it was reversed, MGN was the most common, followed by FSGS [2,3,7,10]. This could be result of our relative liberal biopsy policy, including more patients with AUA, a more likely presentation of FSGS than MGN.…”

“…We routinely use IF and electron microscopy in the renal biopsy analysis in all our patients, and we believe that this is one of the major advantages of our study. Consequently, there is a much bigger prevalence of HERNEF (8.1%) in our study compared to some others [5,10,11,[14][15][16]18]. Recent articles showed that electron microscopy was absolutely necessary to make a correct diagnosis in 21% of cases, while its use resulted in clinically relevant refinement of or addition to the diagnosis in another 24% of cases [31,32].…”

“…In addition, data from local or limited national registries of renal biopsy have been reported from South Korea [10,11], Bahrain [12,13], Brazil [14], Romania [15], China [16], Finland [17], Serbia [18], Pakistan [19] and Belgium [20]. Finally, there are also reports that include epidemiological data only on glomerular diseases from Australia [21], Macedonia [22], France [23], USA [24], Iran [25], Germany [26], Lebanon [27], Peru [28] and Poland [29].…”

A Study on Clinico Pathological Spectrum of Nephrotic Syndrome in Adult Patients in a Teaching Hospital in Eastern India

“…Also in India, a study conducted to identify the spectrum of renal diseases in Indian adults (Agarwal SK, Dash) 6 revealed that among the nephrotic syndrome cases primary glomerulonephritides was seen in 58.5% cases and of which minimal change disease (MCD) was the commonest cause in 38% of cases. In our study, more than 85% cases had primary glomerulonephritides amongst which 34% had MGN, FSGS in 25% and MCD in 20%.Studies by Dragovic et al 7 and Braden GL et al 8 found that FSGS was increasing in incidence in both white as well as black patients. Regarding the outcome of the different glomerular diseases, FSGS had a fairly high progression rate to end-stage renal disease (ESRD) among primary glomerular disease, while diabetes had a high incidence of ESRD among secondary glomerular disease.…”

Histopathological Pattern of Glomerulonephritis: Experience from BIRDEM General Hospital, Dhaka, Bangladesh

“…38 Most of the studies did not mention IgM nephropathy as a distinct category. 13 We did not get any IgA nephropathy in our study.…”