An Analysis of 3,000 Cases of Percutaneous Renal Biopsy-Single Center Study

Korean Journal of Nephrology 2008;27(6):666-677.

Mi Hyun Chang, M.D.1, Eun Ah Hwang, M.D.1, Jung Eun Kim, M.D.1, Jeong Soo Yoon, M.D.1, Woo Young Park, M.D.1, Sung Sik Kang, M.D.1, Seung Yeup Han, M.D.1, Sung Bae Park, M.D.1, Hyun Chul Kim, M.D.1 and Mi Sun Choe, M.D.2

Departments of Internal Medicine1 and Pathology²
Keimyung University School of Medicine, Kidney Institute

임상연구 : 경피적 신생검 3,000예의 분석 - 단일 기관 연구

장미현1, 황은아1, 김정은1, 윤정수1, 박우영1, 강성식1, 한승엽1, 박성배1, 김현철1, 최미선2

계명대학교 의과대학 내과학교실1, 병리학교실2, 계명대학교 신장연구소

Abstract

Purpose : The incidence of glomerular diseases varies according to population characteristics and time period. Methods : A total of 3,000 renal biopsies were performed over the 29 years' period from 1978 to 2007. We reviewed the patient records of all patients who underwent renal biopsies at our institution. The patients were grouped for analysis in three time intervals: before 1990, 1991 to 2000, and after 2001. Results : There were 2,377 cases of native kidney biopsies and 623 cases of allograft kidneys. The principal long-term changes were an increase in the mean age of patients with undergoing biopsy and an increase in the percentage of asymptomatic urinary abnormalities as an indication for biopsy. In the primary glomerulonephritis (GN), the most common pathologic diagnosis was IgA nephropathy (IgAN, 26.6%), followed by minimal change disease (MCD, 21.4%), membranous nephropathy (8.9%), focal segmental glomerulosclerosis (7.7%). The major changes noted in primary GN were a marked increase in the frequency of IgAN and decrease in the frequency of MCD. Major causes of secondary GN were lupus nephritis (37.9%), and hepatitis associated GN (28.9%). In allograft biopsies, acute rejection (42.3%) and chronic rejection (19.4%) were the two most common diagnoses. Documented complications of renal biopsies included perirenal hematoma (25.1%), but the rate of serious complications that required surgical intervention or embolization was very low (1.0%). There was no death or nephrectomy case in our study. Conclusion : IgAN was the most common primary GN in this study. The multi-center studies are needed to evaluate the distribution and changing trends of renal disease in Korea.

Key Words: Renal biopsy, Glomerular disease, Complication