Article

An analysis of 4,514 cases of renal biopsy in Korea.

Department of Pathology, College of Medicine and the Institute of Kidney Disease, Yonsei University, Seoul, Korea.
Yonsei Medical Journal (impact factor: 1.14). 05/2001; 42(2):247-54. pp.247-54
Source: PubMed

ABSTRACT To evaluate the distribution and changing patterns of renal diseases in Korea, a total of 4,514 cases of renal biopsy collected over a 23-year period between 1973 and 1995 were reviewed. Of 4,200 cases excluding 314 unsatisfactory biopsies, adult cases comprised 59.5% and pediatric cases, 40.5%. The male to female ratio was 1.5:1 in adults and 2.2:1 in children. Glomerulonephritis (GN) comprised 80.0% of the total. The most common primary GN in adults was minimal change disease (MCD) (26.6%), followed by IgA nephropathy (IgAN) (22.1%), membranous GN (MGN) (11.8%), and membranoproliferative GN (MPGN) (5.9%). In children, the primary GN incidence rates were MCD (24.8%), IgAN (10.3%), poststreptococcal (including postinfectious) GN (PSGN) (8.6%), and focal segmental glomerulosclerosis (FSGS) (4.0%). The most common secondary GN in adults was lupus nephritis and in children Henoch-Schonlein purpura nephritis. The most common cause of nephrotic syndrome was MCD in both adults and children, followed by MGN and FSGS. The elderly, aged sixty years and older, comprised 2.7% of cases and recorded equal numbers of MCD and MGN. The proportion of the biopsies found to be seropositive for HBs antigen was 27.9%, and these showed either MGN or MPGN pattern. Repeat biopsy was performed in 168 patients, due to previous biopsy failure in 15.5%. When the primary GN cases were analyzed at 5-year intervals, the prevalence of PSGN, which was greater than 25% during the 1973-1982 period, decreased abruptly in children thereafter, whereas the prevalence of FSGS increased slowly since the 1988-1992 period in both adults and children. The decrease of PSGN and the increase of FSGS suggest a role for socioeconomic and environmental factors in Korea.

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Keywords

23-year period
 
314 unsatisfactory biopsies
 
5-year intervals
 
children Henoch-Schonlein purpura nephritis
 
common cause
 
common primary GN
 
common secondary GN
 
female ratio
 
focal segmental glomerulosclerosis
 
IgA nephropathy
 
membranoproliferative GN
 
membranous GN
 
MGN
 
MPGN pattern
 
nephrotic syndrome
 
previous biopsy failure
 
primary GN cases
 
primary GN incidence rates
 
PSGN
 
renal diseases