Kidney biopsy diagnosis in childhood in the Norwegian Kidney Biopsy Registry and the long-term risk of kidney replacement therapy: a 25-year follow-up.
Child
Humans
Adolescent
Young Adult
Adult
Glomerulosclerosis, Focal Segmental
/ pathology
Follow-Up Studies
Retrospective Studies
Glomerulonephritis, IGA
/ pathology
Kidney
/ pathology
Glomerulonephritis, Membranoproliferative
/ pathology
Renal Replacement Therapy
Kidney Failure, Chronic
/ pathology
Registries
Biopsy
/ adverse effects
Children
Chronic kidney disease stage 5
Kidney biopsy
Kidney replacement therapy
National registries
Journal
Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728
Informations de publication
Date de publication:
04 2023
04 2023
Historique:
received:
28
04
2022
accepted:
27
07
2022
revised:
16
07
2022
pubmed:
23
8
2022
medline:
16
2
2023
entrez:
22
8
2022
Statut:
ppublish
Résumé
There is scarce information on biopsy-verified kidney disease in childhood and its progression to chronic kidney disease stage 5 (CKD 5). This study aims to review biopsy findings in children, and to investigate risk of kidney replacement therapy (KRT). We conducted a retrospective long-term follow-up study of children included in the Norwegian Kidney Biopsy Registry (NKBR) and in the Norwegian Renal Registry (NRR) from 1988 to 2021. In total, 575 children with a median (interquartile range, IQR) age of 10.7 (6.1 to 14.1) years were included, and median follow-up time (IQR) after kidney biopsy was 14.3 (range 8.9 to 21.6) years. The most common biopsy diagnoses were minimal change disease (MCD; n = 92), IgA vasculitis nephritis (IgAVN; n = 76), IgA nephropathy (n = 63), and focal and segmental glomerulosclerosis (FSGS; n = 47). In total, 118 (20.5%) of the biopsied children reached CKD 5, median (IQR) time to KRT 2.3 years (7 months to 8.4 years). Most frequently, nephronophthisis (NPHP; n = 16), FSGS (n = 30), IgA nephropathy (n = 9), and membranoproliferative glomerulonephritis (MPGN; n = 9) led to KRT. The risk of KRT after a kidney biopsy diagnosis is highly dependent on the diagnosis. None of the children with MCD commenced KRT, while 63.8% with FSGS and 100% with NPHP reached KRT. Combining data from kidney biopsy registries with registries on KRT allows for detailed information concerning the risk for later CKD 5 after biopsy-verified kidney disease in childhood. A higher resolution version of the Graphical abstract is available as Supplementary information.
Sections du résumé
BACKGROUND
There is scarce information on biopsy-verified kidney disease in childhood and its progression to chronic kidney disease stage 5 (CKD 5). This study aims to review biopsy findings in children, and to investigate risk of kidney replacement therapy (KRT).
METHODS
We conducted a retrospective long-term follow-up study of children included in the Norwegian Kidney Biopsy Registry (NKBR) and in the Norwegian Renal Registry (NRR) from 1988 to 2021.
RESULTS
In total, 575 children with a median (interquartile range, IQR) age of 10.7 (6.1 to 14.1) years were included, and median follow-up time (IQR) after kidney biopsy was 14.3 (range 8.9 to 21.6) years. The most common biopsy diagnoses were minimal change disease (MCD; n = 92), IgA vasculitis nephritis (IgAVN; n = 76), IgA nephropathy (n = 63), and focal and segmental glomerulosclerosis (FSGS; n = 47). In total, 118 (20.5%) of the biopsied children reached CKD 5, median (IQR) time to KRT 2.3 years (7 months to 8.4 years). Most frequently, nephronophthisis (NPHP; n = 16), FSGS (n = 30), IgA nephropathy (n = 9), and membranoproliferative glomerulonephritis (MPGN; n = 9) led to KRT.
CONCLUSIONS
The risk of KRT after a kidney biopsy diagnosis is highly dependent on the diagnosis. None of the children with MCD commenced KRT, while 63.8% with FSGS and 100% with NPHP reached KRT. Combining data from kidney biopsy registries with registries on KRT allows for detailed information concerning the risk for later CKD 5 after biopsy-verified kidney disease in childhood. A higher resolution version of the Graphical abstract is available as Supplementary information.
Identifiants
pubmed: 35994104
doi: 10.1007/s00467-022-05706-y
pii: 10.1007/s00467-022-05706-y
pmc: PMC9925570
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1249-1256Informations de copyright
© 2022. The Author(s).
Références
Nephron Clin Pract. 2009;112(3):c199-204
pubmed: 19439991
Kidney Int. 2009 Sep;76(5):546-56
pubmed: 19571790
Pediatr Nephrol. 2013 Mar;28(3):415-26
pubmed: 23052651
Lancet. 2002 Aug 31;360(9334):666-70
pubmed: 12241872
Ren Fail. 2016 Sep;38(8):1228-33
pubmed: 27430296
Nat Rev Nephrol. 2016 Dec;12(12):768-776
pubmed: 27748392
Saudi J Kidney Dis Transpl. 2014 Nov;25(6):1321-7
pubmed: 25394460
Yonsei Med J. 2001 Apr;42(2):247-54
pubmed: 11371115
Pediatr Nephrol. 2016 Mar;31(3):343-8
pubmed: 26884120
Saudi J Kidney Dis Transpl. 2014 May;25(3):680-3
pubmed: 24821178
Pediatr Nephrol. 2013 Jun;28(6):863-74
pubmed: 22829176
BMC Nephrol. 2020 Feb 26;21(1):65
pubmed: 32102663
N Engl J Med. 2013 Jun 20;368(25):2402-14
pubmed: 23782179
J Bras Nefrol. 2013 Jul-Sep;35(3):191-9
pubmed: 24100738
Arthritis Rheum. 2013 Jan;65(1):1-11
pubmed: 23045170
J Am Soc Nephrol. 2000 Feb;11(2):319-329
pubmed: 10665939
Kidney Int. 2012 Oct;82(7):790-6
pubmed: 22673888
Am J Nephrol. 2020;51(1):43-53
pubmed: 31822006
Nat Rev Nephrol. 2016 Mar;12(3):133-46
pubmed: 26750453
Ital J Pediatr. 2017 Apr 21;43(1):41
pubmed: 28427453
Nat Rev Dis Primers. 2020 Aug 13;6(1):68
pubmed: 32792490
Front Immunol. 2021 Nov 09;12:771619
pubmed: 34858429
Nat Rev Nephrol. 2014 Oct;10(10):563-73
pubmed: 25072122
J Pediatr. 1995 Dec;127(6):913-9
pubmed: 8523188
Kidney Int. 2011 Oct;80(8):798-801
pubmed: 21960168
Kidney Int. 2018 Mar;93(3):700-705
pubmed: 29329643
Saudi J Kidney Dis Transpl. 2015 Jul-Aug;26(4):810-5
pubmed: 26178566
Clin J Am Soc Nephrol. 2011 Aug;6(8):2034-40
pubmed: 21700827
Pediatr Nephrol. 2006 Sep;21(9):1266-73
pubmed: 16838184
Pediatr Nephrol. 2012 Mar;27(3):363-73
pubmed: 21713524
Pediatr Transplant. 2007 Jun;11(4):366-73
pubmed: 17493215
J Nephrol. 2009 Nov-Dec;22(6):739-46
pubmed: 19967653
Kidney Dis (Basel). 2018 Feb;4(1):10-19
pubmed: 29594138
Clin J Am Soc Nephrol. 2012 Oct;7(10):1591-7
pubmed: 22837269
Kidney360. 2021 May 28;2(8):1339-1348
pubmed: 35369654
Pediatr Nephrol. 1994 Feb;8(1):15-20
pubmed: 8142218
Lancet. 1992 Feb 1;339(8788):280-2
pubmed: 1346291
Nephrol Dial Transplant. 1998 Feb;13(2):293-7
pubmed: 9509437
J Pediatr. 1985 Jan;106(1):27-32
pubmed: 2981307
J Clin Med. 2021 May 25;10(11):
pubmed: 34070665