Ten-year review of disease pattern from percutaneous renal biopsy: an experience from a paediatric tertiary renal centre in Hong Kong.
| Autor: | Yuen LK; Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong. slkyuen62@gmail.com, Lai WM, Lau SC, Tong PC, Tse KC, Chiu MC |
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| Jazyk: | angličtina |
| Zdroj: | Hong Kong medical journal = Xianggang yi xue za zhi [Hong Kong Med J] 2008 Oct; Vol. 14 (5), pp. 348-55. |
| Abstrakt: | Objective: To study the childhood renal disease pattern based on the renal biopsy histology in a local paediatric tertiary renal centre. Design: Retrospective study. Setting: Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong. Patients: All patients who underwent real-time ultrasound-guided closed renal biopsy from 1 April 1997 to 31 March 2007 were included. Results: A total of 209 renal biopsies were performed, 162 on native kidneys and 47 on grafts. In the native group, major indications were renal manifestations secondary to systemic diseases (34%), followed by idiopathic nephrotic syndrome (28%) and haematuria (27%). In 94% the histopathology revealed glomerular diseases. Among the primary glomerular diseases, thin glomerular basement membrane disease, immunoglobulin A nephropathy, minimal change disease, and focal segmental glomerulosclerosis accounted for most. In all, 37% of patients with steroid-resistant nephrotic syndrome had focal segmental glomerulosclerosis and its relative incidence was increased when compared to previous studies. Minimal change disease and minimal change disease with mesangial immunoglobulin M deposits accounted for the majority of steroid dependent and frequent relapsers. Among patients with isolated microscopic haematuria, 73% had thin glomerular basement membrane disease, while patients with concomitant haematuria and proteinuria had a wide variety of pathology. In the kidney graft group, acute graft dysfunction was due to acute rejection in 38% of the patients, followed by calcineurin inhibitor toxicity in 14%. Chronic allograft nephropathy caused chronic allograft dysfunction in the majority of cases. Post-transplant proteinuria was caused by recurrence of the primary renal disease in all of our patients. Conclusion: This study provides updated epidemiological information for childhood renal disease and a change in the pattern of disease was observed. |
| Databáze: | MEDLINE |
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