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,Pediatric Nephrology

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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
Pediatric Nephrology ( IF 2.6 ) Pub Date : 2022-08-22 , DOI: 10.1007/s00467-022-05706-y
Ann Christin Gjerstad ₁ , Rannveig Skrunes _{2,

3} , Camilla Tøndel _{4,

5} , Anders Åsberg _{6,

7,

8} , Sabine Leh _{3,

9} , Claus Klingenberg _{10,

11} , Henrik Døllner _{12,

13} , Clara Hammarstrøm ₁₄ , Anna Kristina Bjerre _{1,

15}

Affiliation

Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.
Department of Medicine, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.
Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.
The Norwegian Renal Registry, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
Department of Transplantation Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
Department of Pharmacy, University of Oslo, Oslo, Norway.
Department of Pathology, Haukeland University Hospital, Bergen, Norway.
Department of Pediatrics and Adolescence Medicine, University Hospital of North Norway, Tromsø, Norway.
Paediatric Research Group, Faculty of Health Sciences, UiT-The Arctic University of Norway, Tromsø, Norway.
Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Children's Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Department of Pathology, Oslo University Hospital - Rikshospitalet, Oslo, Norway.
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

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.

Graphical abstract

A higher resolution version of the Graphical abstract is available as Supplementary information

中文翻译：

挪威肾脏活检登记处儿童期肾脏活检诊断和肾脏替代治疗的长期风险：25 年随访

背景

关于经活检证实的儿童肾病及其进展为慢性肾病 5 期 (CKD 5) 的信息很少。本研究旨在回顾儿童的活检结果，并调查肾脏替代疗法 (KRT) 的风险。

方法

我们对 1988 年至 2021 年挪威肾脏活检登记处 (NKBR) 和挪威肾脏登记处 (NRR) 中的儿童进行了一项回顾性长期随访研究。

结果

总共纳入了 575 名中位（四分位数间距，IQR）年龄为 10.7（6.1 至 14.1）岁的儿童，肾活检后的中位随访时间 (IQR) 为 14.3（范围 8.9 至 21.6）年。最常见的活检诊断是微小病变（MCD；n = 92）、IgA 血管炎性肾炎（IgAVN；n = 76）、IgA 肾病（n = 63）和局灶节段性肾小球硬化症（FSGS；n = 47）。总共有 118 名 (20.5%) 的活检儿童达到 CKD 5，中位 (IQR) 时间至 KRT 为 2.3 年（7 个月至 8.4 年）。最常见的是肾病（NPHP；n = 16）、FSGS（n = 30）、IgA 肾病（n = 9), 和膜增生性肾小球肾炎 (MPGN; n = 9) 导致 KRT。