Epidemiology and clinicopathological characteristics of native kidney disease in children in Flanders, Belgium.


Journal

Pediatric nephrology (Berlin, Germany)
ISSN: 1432-198X
Titre abrégé: Pediatr Nephrol
Pays: Germany
ID NLM: 8708728

Informations de publication

Date de publication:
05 2023
Historique:
received: 26 04 2022
accepted: 02 08 2022
revised: 07 07 2022
medline: 31 3 2023
pubmed: 14 10 2022
entrez: 13 10 2022
Statut: ppublish

Résumé

The Flemish Collaborative Glomerulonephritis Group (FCGG) registry is a population-based kidney biopsy registry that has been including all native kidney biopsies performed in children in Flanders (Belgium), since 2017. From 2017 to 2020, 148 pediatric (< 18 years) native kidney biopsies were included. Each biopsy received a histopathological and final nephrological diagnosis, and concordance between both was assessed. Disease chronicity, summarized by the Mayo Clinic Chronicity Score, was determined on 122 biopsies with > 5 glomeruli. Kidney biopsy rate was high (29.0 biopsies per million children per year), median age was 10.0 years (IQR 5.8-14.7), and boys predominated (56.1% males). A total of 140 biopsies (94.6%) showed a representative pathology result. Glomerular disease was most prevalent, with IgA nephropathy/IgA vasculitis (43 biopsies, 29.1%) and minimal change disease (MCD) (29 biopsies, 19.6%) being the overall most frequent diagnoses. In general, diagnostic concordance was high (80.7%). In Alport syndrome and focal segmental glomerulosclerosis (FSGS), concordance was lower, as the nephrological diagnosis was often determined by results of genetic analysis. Nephrotic syndrome was the most frequent indication for kidney biopsy (31.8%) and was mainly caused by MCD and FSGS. The degree of disease chronicity on kidney biopsies was generally low, although 27.3% of biopsies with a diagnosis of FSGS showed moderate-to-severe chronic damage. The presented epidemiological findings validate data from previous European registry studies and may inspire kidney biopsy registries worldwide to implement novel features such as clinicopathological concordance and chronicity grading. A higher resolution version of the Graphical abstract is available as Supplementary information.

Sections du résumé

BACKGROUND
The Flemish Collaborative Glomerulonephritis Group (FCGG) registry is a population-based kidney biopsy registry that has been including all native kidney biopsies performed in children in Flanders (Belgium), since 2017.
METHODS
From 2017 to 2020, 148 pediatric (< 18 years) native kidney biopsies were included. Each biopsy received a histopathological and final nephrological diagnosis, and concordance between both was assessed. Disease chronicity, summarized by the Mayo Clinic Chronicity Score, was determined on 122 biopsies with > 5 glomeruli.
RESULTS
Kidney biopsy rate was high (29.0 biopsies per million children per year), median age was 10.0 years (IQR 5.8-14.7), and boys predominated (56.1% males). A total of 140 biopsies (94.6%) showed a representative pathology result. Glomerular disease was most prevalent, with IgA nephropathy/IgA vasculitis (43 biopsies, 29.1%) and minimal change disease (MCD) (29 biopsies, 19.6%) being the overall most frequent diagnoses. In general, diagnostic concordance was high (80.7%). In Alport syndrome and focal segmental glomerulosclerosis (FSGS), concordance was lower, as the nephrological diagnosis was often determined by results of genetic analysis. Nephrotic syndrome was the most frequent indication for kidney biopsy (31.8%) and was mainly caused by MCD and FSGS. The degree of disease chronicity on kidney biopsies was generally low, although 27.3% of biopsies with a diagnosis of FSGS showed moderate-to-severe chronic damage.
CONCLUSIONS
The presented epidemiological findings validate data from previous European registry studies and may inspire kidney biopsy registries worldwide to implement novel features such as clinicopathological concordance and chronicity grading. A higher resolution version of the Graphical abstract is available as Supplementary information.

Identifiants

pubmed: 36227435
doi: 10.1007/s00467-022-05719-7
pii: 10.1007/s00467-022-05719-7
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1533-1545

Informations de copyright

© 2022. The Author(s), under exclusive licence to International Pediatric Nephrology Association.

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Auteurs

Dries Deleersnijder (D)

Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Louvain, Belgium. dries.deleersnijder@kuleuven.be.
Division of Nephrology, University Hospitals Leuven, Louvain, Belgium. dries.deleersnijder@kuleuven.be.

Noël Knops (N)

Pediatric Nephrology and Solid Organ Transplantation, University Hospitals Leuven, Louvain, Belgium.
Department of Development and Regeneration, KU Leuven, Louvain, Belgium.

Dominique Trouet (D)

Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Wilrijk, Belgium.
Department of Pediatric Nephrology, Antwerp University Hospital, Edegem, Belgium.

Koen Van Hoeck (K)

Department of Pediatric Nephrology, Antwerp University Hospital, Edegem, Belgium.

Sevasti Karamaria (S)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium.

Johan Vande Walle (J)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium.

Reiner Mauel (R)

Department of Pediatrics, University Hospital Brussels, Brussels, Belgium.

Louise Cools (L)

Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Louvain, Belgium.

Gert Meeus (G)

Department of Nephrology, AZ Groeninge Hospital, Kortrijk, Belgium.

Amélie Dendooven (A)

Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Wilrijk, Belgium.
Division of Pathology, University Hospital Ghent, Ghent, Belgium.

Johan De Meester (J)

Department of Nephrology and Dialysis, VITAZ Hospital, Sint-Niklaas, Belgium.

Wim Laurens (W)

Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium.
Department of Nephrology and Dialysis, VITAZ Hospital, Sint-Niklaas, Belgium.

Ben Sprangers (B)

Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Louvain, Belgium. ben.sprangers@zol.be.
Division of Nephrology, University Hospitals Leuven, Louvain, Belgium. ben.sprangers@zol.be.

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