Clinicopathologic correlations of renal pathology in the adult population of Poland.
BACKGROUND
This is the first report on the epidemiology of biopsy-proven kidney diseases in Poland.


METHODS
The Polish Registry of Renal Biopsies has collected information on all (n = 9394) native renal biopsies performed in Poland from 2009 to 2014. Patients' clinical data collected at the time of biopsy, and histopathological diagnoses were used for epidemiological and clinicopathologic analysis.


RESULTS
There was a gradual increase in the number of native renal biopsies performed per million people (PMP) per year in Poland in 2009-14, starting from 36 PMP in 2009 to 44 PMP in 2014. A considerable variability between provinces in the mean number of biopsies performed in the period covered was found, ranging from 5 to 77 PMP/year. The most common renal biopsy diagnoses in adults were immunoglobulin A nephropathy (IgAN) (20%), focal segmental glomerulosclerosis (FSGS) (15%) and membranous glomerulonephritis (MGN) (11%), whereas in children, minimal change disease (22%), IgAN (20%) and FSGS (10%) were dominant. Due to insufficient data on the paediatric population, the clinicopathologic analysis was limited to patients ≥18 years of age. At the time of renal biopsy, the majority of adult patients presented nephrotic-range proteinuria (45.2%), followed by urinary abnormalities (38.3%), nephritic syndrome (13.8%) and isolated haematuria (1.7%). Among nephrotic patients, primary glomerulopathies dominated (67.6% in those 18-64 years of age and 62.4% in elderly patients) with leading diagnoses being MGN (17.1%), FSGS (16.2%) and IgAN (13.0%) in the younger cohort and MGN (23.5%), amyloidosis (18.8%) and FSGS (16.8%) in the elderly cohort. Among nephritic patients 18-64 years of age, the majority (55.9%) suffered from primary glomerulopathies, with a predominance of IgAN (31.3%), FSGS (12.7%) and crescentic GN (CGN) (11.1%). Among elderly nephritic patients, primary and secondary glomerulopathies were equally common (41.9% each) and pauci-immune GN (24.7%), CGN (20.4%) and IgAN (14.0%) were predominant. In both adult cohorts, urinary abnormalities were mostly related to primary glomerulopathies (66.8% in younger and 50% in elderly patients) and the leading diagnoses were IgAN (31.4%), FSGS (15.9%), lupus nephritis (10.7%) and FSGS (19.2%), MGN (15.1%) and pauci-immune GN (12.3%), respectively. There were significant differences in clinical characteristics and renal biopsy findings between male and female adult patients.


CONCLUSIONS
The registry data focused new light on the epidemiology of kidney diseases in Poland. These data should be used in future follow-up and prospective studies.
Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Agnieszka
A
Perkowska-Ptasinska
Department of Pathology, Medical Center of Postgraduate Education, Warsaw, Poland.
Artur
A
Bartczak
Department of Pathology, Uniwersytet Medyczny w Lodzi, Lodz, Poland.
Malgorzata
M
Wagrowska-Danilewicz
Department of Pathomorphology, Wroclaw Medical University, Wroclaw, Poland.
Agnieszka
A
Halon
Department of Clinical and Experimental Pathology, Jagiellonian University, Collegium Medicum, Krakow, Poland.
Krzysztof
K
Okon
Biopsy Diagnostics Laboratory, Poznan University of Medical Sciences, Poznan, Poland.
Aldona
A
Wozniak
Department of Pathology, Uniwersytet Medyczny w Lodzi, Lodz, Poland.
Marian
M
Danilewicz
Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Katowice, Poland.
Henryk
H
Karkoszka
Department of Pathomorphology, Nicolaus Copernicus University, Bydgoszcz, Poland.
Andrzej
A
Marszalek
Department of Pathology, Eastern Virginia Medical School, Norfolk, VA, USA.
Jolanta
J
Kowalewska
Department of Pathology, Medical Center of Postgraduate Education, Warsaw, Poland.
Andrzej
A
Mroz
Pathology Department, Uniwersytet Medyczny w Lublinie, Lublin, Poland.
Agnieszka
A
Korolczuk
Department of Nephrology, Transplantology, and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.
Andrzej
A
Oko
Department of Nephrology, Transplantation and Internal Medicine, Medical University of Gdansk, Gdansk, Poland.
Alicja
A
Debska-Slizien
Department of Nephrology and Transplantology with Dialysis Unit, Medical University Bialystok, Bialystok, Poland.
Beata
B
Naumnik
Department of Nephrology, with subdivision of Diabetology and Transplantology, District Specialist Hospital in Wroclaw, Wroclaw, Poland.
Zbigniew
Z
Hruby
Department of Nephrology and Transplantation Medicine, Wroclaw Medical University, Wroclaw, Poland.
Marian
M
Klinger
Clinic of Nephrology, Transplantology and Internal Diseases, Pomeranian Medical University, Szczecin, Poland.
Kazimierz
K
Ciechanowski
Department of Nephrology and Kidney Transplantation, District Hospital in Szczecin, Szczecin, Poland.
Marek
M
Myslak
Department of Nephrology, Jagiellonian University, Krakow, Poland.
Wladyslaw
W
Sulowicz
Department of Internal Diseases, Nephrology and Transplantology, Central Clinical Hospital of the Ministry of Interior, Warsaw, Poland.
Andrzej
A
Rydzewski
Department of Nephrology, Silesian School of Medicine, Katowice, Poland.
Andrzej
A
Wiecek
Department of Nephrology, Hypertension and Internal Medicine, Collegium Medicum UMK, Bydgoszcz, Poland.
Jacek
J
Manitius
Department of Nephrology, District Hospital in Kielce, Kielce, Poland.
Tadeusz
T
Gregorczyk
Department of Internal Diseases, Nephrology and Dialysis, Military Institute of Medicine, Warsaw, Poland.
Stanislaw
S
Niemczyk
Department of Nephrology, Hypertension and Kidney Transplantation, Medical University of Lodz, Lodz, Poland.|Nephrology and Dialysis, Polish Mother's Memorial Hospital, Lodz, Poland.
Michal
M
Nowicki
Department of Nephrology, Medical Center for Postgraduate Education, Warsaw, Poland.
Ryszard
R
Gellert
PD Unit, Chair and Department of Nephrology, Jagiellonian University, Cracow, Poland.
Tomasz
T
Stompor
Department of Nephrology, Dialysis, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
Monika
M
Wieliczko
Zaklad Etyki i Filozofii Czlowieka, Uniwersytet Medyczny w Lublinie, Lublinie, Poland.
Krzysztof
K
Marczewski
Department of Immunology, Transplant Medicine, and Internal Diseases, Medical University of Warsaw, Warsaw, Poland.
Leszek
L
Paczek
Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Olga
O
Rostkowska
Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Dominika
D
Deborska-Materkowska
Department of Nephrology, Regional Medical Centre in Opole, Poland.
Grazyna
G
Bogdanowicz
Dialysis Centre, Fresenius Nephrocare in Krakow, Poland.
Andrzej
A
Milkowski
Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Magdalena
M
Durlik
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007668:Kidney / Q000473:pathology*; D007674:Kidney Diseases / Q000453:epidemiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D011446:Prospective Studies; D012042:Registries; D017678:Sex Distribution; D055815:Young Adult
annual incidence of renal biopsy; epidemiology of kidney diseases; glomerular diseases; renal biopsies registry; renal biopsy diagnoses