Ten-year review of disease pattern from percutaneous renal biopsy: an experience from a paediatric tertiary renal centre in Hong Kong.
OBJECTIVE
To study the childhood renal disease pattern based on the renal biopsy histology in a local paediatric tertiary renal centre.


METHODS
Retrospective study.


METHODS
Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Hong Kong.


METHODS
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.


CONCLUSIONS
This study provides updated epidemiological information for childhood renal disease and a change in the pattern of disease was observed.
Department of Paediatrics and Adolescent Medicine, Princess Margaret Hospital, Laichikok, Hong Kong. slkyuen62@gmail.com
L K
LK
Yuen
W M
WM
Lai
S C
SC
Lau
P C
PC
Tong
K C
KC
Tse
M C
MC
Chiu
D000293:Adolescent; D044963:Biopsy, Fine-Needle; D065095:Calcineurin Inhibitors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection; D006417:Hematuria / Q000209:etiology; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D007223:Infant; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D007678:Kidney Glomerulus; D016030:Kidney Transplantation; D008297:Male; D011507:Proteinuria / Q000209:etiology; D012189:Retrospective Studies
D065095:Calcineurin Inhibitors; D007166:Immunosuppressive Agents