[Analysis of the spectrum of nephropathies over 24 years in a West German center based on native kidney biopsies].
OBJECTIVE
The aim of the study was to analyze the occurrence of primary and secondary glomerulopathies as well as tubulointerstitial nephropathies over time and to assess potential changes in the disease spectrum.


METHODS
The authors retrospectively analyzed all kidney biopsies performed in their institution between 1983 and 2006 as well as the clinical data at the time of biopsy.


RESULTS
Between January 1983 and December 2006, 359 native kidney biopsies with sufficient material for histological analysis were performed (218 men, 141 women; mean age 51.8 years). A mean of nine glomeruli per biopsy were obtained. Mean serum creatinine at the time of biopsy was 3.3 mg/dl. The most common indication for biopsy was nephrotic syndrome (31%), followed by renal insufficiency (29%) and proteinuria (14%). Primary glomerulopathies were found in 51%, secondary glomerulopathies in 28%, tubulointerstitial renal diseases in 9%, and vascular renal diseases in 12%. Among the primary glomerulopathies, IgA nephropathy was the most common diagnosis (26%), followed by mesangioproliferative glomerulonephritis (17%), membranous glomerulonephritis (16%), minimal change disease (14%), focal segmental glomerulosclerosis (FSGS; 13%), rapidly progressive glomerulonephritis (RPGN; 8%), and membranoproliferative glomerulonephritis (7%). Among the secondary glomerulopathies, the heterogeneous group of autoimmune diseases (26%) and diabetic nephropathy (25%) dominated. Comparing the period from 1983 to 1994 with 1995 to 2006, a decrease in primary FSGS from 16% to 9% as well as in RPGN from 14% to 1% was noticed, while among the secondary forms, autoimmune diseases with renal involvement increased from 14% to 31%.


CONCLUSIONS
In the own patient population changes in the spectrum of primary and secondary glomerulopathies can be observed over time. Thereby, the distribution pattern of the various glomerulonephritides largely corresponds to the distribution described for other West European countries. An increase in the incidence of primary FSGS, as observed in non-European countries, could not be demonstrated.
Klinik für Kardiologie (Kardiologie, Elektrophysiologie, Nephrologie und Intensivmedizin), Krankenhaus St. Franziskus, Kliniken Maria Hilf, Mönchengladbach, Germany.
Timo
T
Werner
Hans-Peter
HP
Brodersen
Ulf
U
Janssen
D015984:Causality; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005060:Europe; D005260:Female; D005858:Germany; D005921:Glomerulonephritis / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D007678:Kidney Glomerulus / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology*; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D011507:Proteinuria / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D051437:Renal Insufficiency / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D012189:Retrospective Studies
D003404:Creatinine