Nephrology Dialysis Transplantation, Vol 12, Issue 3 418-426, Copyright © 1997 by Oxford University Press
FP Schena
PURPOSE: This report describes data collected by the Italian Registry of
Renal Biopsies (IRRB) (E mail http://www.teseo.it/nephrology/irrb), which
includes 15461 renal biopsies (RB) performed over a period of 7 years
(1987-1993). METHODS: From 1987 to 1988, the Registry recorded only the
histological diagnosis of 3686 RB, whereas beginning in 1989, additional
records (sex, age, clinical symptoms and renal function) were obtained from
11,775 patients undergoing RB. This is the first report on such a large
number of RB containing data from 96% of Italian renal units which
routinely perform RB. RESULTS: In 13,835 RB performed in native kidneys,
two groups of renal diseases, primary (59.9%) and secondary (25.4%)
glomerulonephritis (gn), were more frequent than others. Among primary gn,
the frequency of cases of IgAN, membranous gn, and focal and segmental
glomerulosclerosis were 36.9, 21.7 and 10.4% respectively. Renal disease
due to immune-mediated causes (51%) and dysgammaglobulinaemia (26.9%) were
the most frequent among secondary gn. In the former group, the frequency of
cases with lupus nephritis and vasculitis were 51.6 and 25.9% respectively.
Renal amyloidosis (39.3%), essential mixed cryoglobulinaemia (30.9%), and
multiple myeloma were the most frequent forms in the latter group. In 1993
the incidence of the following groups of renal disease was: primary gn
(22.7 p.m.p.), secondary gn (11.1 p.m.p.) of which immune- mediated gn (5.8
p.m.p.), dysgammaglobulinaemias associated with nephritis (2.4 p.m.p.).
IgAN and membranous gn, as primary gn, had an incidence of 8.4 and 4.9
p.m.p, respectively, while lupus nephritis (2.6 p.m.p.) and renal
vasculitis (1.6 p.m.p.) were the most frequent forms of secondary gn.
Clinical data regarding 10357 RB collected during 5 years (1989-1993),
showed that the most common indications to perform RB were urinary
abnormalities (30.8%) and nephrotic syndrome (27.1%), followed by recurrent
episodes of macrohaematuria (8.7%) and nephritic syndrome (5.4%). Acute
renal failure was present in 9.2% of patients and chronic renal
insufficiency in 18.8% of cases. Membranous gn (32.9%), focal and segmental
glomerulosclerosis (12.3%), and minimal- change disease (12.0%) were the
most frequent diagnoses in patients with nephrotic syndrome, while
post-streptococcal gn (16.1%) and IgAN (14.0%) were frequent in the
nephritic syndrome. IgAN was frequently found in patients with urinary
abnormalities (29.8%) and recurrent episodes of macrohematuria (71.4%).
Twenty per cent of the acute renal insufficiency cases were secondary to
necrotizing vasculitis, while chronic renal failure was present in 16.6% of
the IgAN patients. FUTURE TRENDS: The IRRB is considering to extend its
programme to include (i) paediatric section regarding RB from patients aged
less than 18 years; (ii) annual review of clinical data concerning the
kidney function of selected groups of patients recorded in IRRB, and (iii)
the listing of IRRB records on the INTERNET, to facilitate the distribution
of information throughout the scientific community.
ORIGINAL ARTICLES
Survey of the Italian Registry of Renal Biopsies. Frequency of the renal diseases for 7 consecutive years. The Italian Group of Renal Immunopathology
Institute of Nephrology, University of Bari, Italy.
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