Nephrology Dialysis Transplantation, Vol 13, Issue 2 291-295, Copyright © 1998 by Oxford University Press
R Coppo, B Gianoglio, M Porcellini and S Maringhini
Background. Children's renal biopsy data were gathered
for 3 consecutive years (1992-1994) by the Group of Renal Immunopathology
of the Italian Society of Pediatric Nephrology, which opened a paediatric
section of the Italian Registry of Renal Biopsies. Materials.
The Registry recorded the histological diagnosis and the
clinical data at renal biopsy of 432 children ⩽15 years old (mean
age 8.96±3.7 years). Results. The most
common glomerulonephritis (GN) at renal biopsy was idiopathic IgAGN (18.8%)
and the most frequent secondary GN was Henoch-Schonlein purpura (HSP)
nephritis (11.6%). Minimal-change disease (MCD) accounted for 11.6%, focal
and segmental sclerosis (FSG) 8.5%, mesangial proliferative GN (MPGN) 9.5%,
membranoproliferative GN 5.5%, and thin-membrane disease 5%. Lupus
nephritis was diagnosed in 5% and Alport's GN in 3.9% of the cases. The
annual incidence of primary GN in Italian children was 11.1 cases per
million children population (p.m.c.p.), IgAN accounting for 3.1 cases, MCD
2.3, and HSP nephritis 1.9 cases p.m.c.p. respectively. Italian children
underwent renal biopsy because of isolated microscopic haematuria in 19.3%
of the cases, non-nephrotic proteinuria with or without microscopic
haematuria in 31.2%, and nephrotic-range proteinuria in 34.2%, less
frequently (15.3%) because of acute or chronic renal failure. Children with
persistent isolated microscopic haematuria had most frequently IgAN (34.9%)
or thin-membrane disease (25.3%), while those with non-nephrotic
proteinuria had IgAN (30.4%) and HSP nephritis (23%). In cases with
nephrotic proteinuria renal biopsy showed MCD in 34.5% of the cases, FSG in
16.9%, and MPGN in 12.2%. When renal biopsy was performed in chronic renal
failure chronic interstitial renal disease was detected in 62.5% of the
cases. Conclusions. This National Registry provides
data on the indications for performing renal biopsy in Italian children and
on the frequency and annual incidence of histological lesions detected.
IgAN, primary or related to HSP, was the most common nephritis in Italian
children undergoing renal biopsy. Keywords:
epidemiology; renal biopsy; registry; haematuria; nephrotic syndrome;
children
ORIGINAL ARTICLES
Frequency of renal diseases and clinical indication for renal biopsy in children (Report of the Italian National Registry of Renal Biopsies in Children)
Group of Renal Immunopathology of the Italian Society of Pediatric Nephrology and Group of Renal Immunopathology of the Italian Society of Nephrology, Italy; Nephrology and Dialysis Department, Regina Margherita Children's Hospital, P Polonia 94, I-10126 Torino, Italy; Corresponding author
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