Incidence of primary glomerulonephritis in a large North-Eastern Italian area: a 13-year renal biopsy study.

Abstract

BACKGROUND:

The reported incidence of biopsy-proven primary glomerulonephritis (PGN) varies according to geographical, temporal and environmental factors. Consequently, the development of national/regional registers may help clinicians and researchers to improve knowledge about this important clinical condition.

METHODS:

To better define the epidemiology of PGN in our North-Eastern Italian area (∼5 million inhabitants), we evaluated the kidney biopsy records of 2680 adult patients with PGN diagnosis reported from 1998 to 2010 in the 'Triveneto' Register of Renal Biopsies.

RESULTS:

Statistical analysis showed that the mean age of patients undergoing renal biopsy was gradually increased from 1998 to 2010 (R(2) = 0.82, P < 0.01) with a growing percentage of those aged over 65 years (R(2) = 0.72, P < 0.01). According to the clinical presentation of our PGN patients, we found a significant increase in biopsies performed for acute renal failure (P < 0.01) and a decrement of those for macroscopic haematuria (P < 0.01) and nephritic syndrome (P = 0.04). Moreover, although there has been an unchanged total annual rate of biopsy-proven PGN (P = 0.47), there has been a significant enhancement in the incidence of minimal change disease (MCD, P = 0.04) and extracapillary proliferative glomerulonephritis (ExGN, P = 0.03) over time primarily due to a progressive increase in the mean age of patients affected by both renal diseases. Immunoglobulin A (IgA) nephropathy was the most common glomerulonephritis.

CONCLUSIONS:

Therefore, even if the number of PGN did not diminish during the 13-year study period, we reported considerable changes in the demographical and clinical characteristics of our biopsied patients (older and with acute kidney injury). Additionally, we found a change in the bioptic pattern of our patients over time with a progressive rise of some histological features such as MCD and ExGN. This may reflect not only the progressive ageing of our nephrology patients, but also a change in the biopsy policy of local hospitals.

• Authors: Gianluigi Zaza, Patrizia Bernich, Antonio Lupo, ‘Triveneto’ Register of Renal Biopsies (TVRRB)
• Journal: Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association (Nephrol Dial Transplant) Vol. 28 Issue 2 Pg. 367-72 (Feb 2013) ISSN: 1460-2385 [Electronic] England
• PMID: 23223218 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Biopsy
• Female
• Glomerulonephritis (epidemiology, pathology)
• Glomerulonephritis, IGA (epidemiology, pathology)
• Humans
• Incidence
• Italy (epidemiology)
• Kidney (pathology)
• Longitudinal Studies
• Male
• Middle Aged
• Nephrosis, Lipoid (epidemiology, pathology)
• Registries
• Retrospective Studies