KOR

e-Article

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.
Document Type
Article
Source
Pediatric Nephrology. Apr2023, Vol. 38 Issue 4, p1249-1256. 8p. 3 Charts, 2 Graphs.
Subject
*KIDNEY disease diagnosis
*THERAPEUTICS
*PATIENT aftercare
*REPORTING of diseases
*BIOPSY
*NEPHRITIS
*RENAL replacement therapy
*RETROSPECTIVE studies
*RISK assessment
*DESCRIPTIVE statistics
*RESEARCH funding
*GLOMERULONEPHRITIS
*CYSTIC kidney disease
*LONGITUDINAL method
*SECONDARY analysis
*FOCAL segmental glomerulosclerosis
*URINARY calculi
*DISEASE complications
*CHILDREN
CHRONIC kidney failure complications
Language
ISSN
0931-041X
Abstract
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 [ABSTRACT FROM AUTHOR]