Spectrum of glomerulonephritis observed in native renal biopsies in adults between 2002-2010 in Farabi Hospital

SUMMARYAim: The aim of this study is to investigate the frequency of renal diseases according to age, sex, clinical renal biopsy indications and renal functions based on histopathological diagnosis and the correlation between clinical and histopathological signs.Materials and methods: The study was performed retrospectively in the Nephrology Department of Karadeniz Techinel University Medical School. One hundred thirteen adult patients, whose percutaneous renal biopsy was performed between 2002-2010 and whose clinical records were accessible were included in the study. The biopsies of transplant kidneys and the patients whose records were inaccessible have not been included. Renal biopsy indications were as; nephrotic syndrome, nonnephrotic proteinuria, nephrotic proteinuria, acute nephritic sydrome (focal and diffuse), isolated hematuria and acute renal failure. Renal diseases because of which biopsy performed, classified as glomerulonephritis (primary and secondary), tubulointerstial diseases, vascular nephropathy, widespread glomerulosclerosis & end stage renal disease and unclassified glomerulonephritis & nondiagnostic pathology. Clinical and pathological findings were compared according to age and sex.Results: A total of 113 biopsies were analyzed. The mean glomerulus number was 11.68 ±7.195 (range, 0-33). All the patients, 76 (67.2%) were male and 37(32.8%) were famele. The male to female ratio was 2.05:1. The mean patient age was 43.99±15.402 (range, 18-81) years. Glomerulonephritis was the commonest diagnosis 77% of all biopsies. The ratio of primary glomerulonephritis was higher than secondary glomerulonephritis secondary glomerulonephritis. The most common indications of renal biopsy were nephrotic syndrome (43.4%) followed by isolated nonnephrotic proteinuria (22.1%), acute nephritic sydrome (focal and diffuze) (14.1%), isolated nephrotic proteinuria (13.3%) and acute renal failure (7.1%). Among the primary glomerulonephritis cases, the most common two diagnosis were focal segmental glomerulosclerosis (FSGS; 21.9%) and memmbranous glomerulonephritis (MGN; 21.9%), followed by membranoproliferative glomerulonephritis (MPGN; 13.7%), IgA nephropathy (IgAN; 12.3%), mesengioproliferative glomerulonephritis (MesPGN 12.3%), minimal change disease (MDH; 5.5%), post infectious glomerulonephritis (5.5 %), chronic glomerulonephritis (2.7%), crescentic glomerulonephritis (2.7%), focal glomerulonephritis (1.4%). The most common secondary glomerulonephritis was amyloidosis (50%), followed by diabetic nephropathy (28.6%), lupus nephritis (14.3%), Myeloma kidney (7.1%). When all the renal biopsies were considered, the ratio complications (7.1%) were low. The major complications didn?t occur.Conclusion: The result of the study in which renal biopsies, performed during a 8 years period in our study was correlated with long period, multicenter and large biopsy series literature. The prevalence of biopsy-proven renal disease varises considerably according to race, age, geographic areas, socioeconomic conditions, and indications for renal biopsy. Multicenter, long-period, prospective studies should be done to achieve reliable prognostic datas about glomerular diseases that are diagnosed with renal biopsy and the common causes of end stage renal diseases in Turkey.Key Words: Renal biopsy, indications, glomerulonephritis.