Dries Deleersnijder1,2, Noël Knops3,4, Dominique Trouet5,6, Koen Van Hoeck6, Sevasti Karamaria7,8, Johan Vande Walle7,8, Reiner Mauel9, Louise Cools10, Gert Meeus11, Amélie Dendooven5,12, Johan De Meester13, Wim Laurens7,13, Ben Sprangers14,15. 1. Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Louvain, Belgium. dries.deleersnijder@kuleuven.be. 2. Division of Nephrology, University Hospitals Leuven, Louvain, Belgium. dries.deleersnijder@kuleuven.be. 3. Pediatric Nephrology and Solid Organ Transplantation, University Hospitals Leuven, Louvain, Belgium. 4. Department of Development and Regeneration, KU Leuven, Louvain, Belgium. 5. Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Wilrijk, Belgium. 6. Department of Pediatric Nephrology, Antwerp University Hospital, Edegem, Belgium. 7. Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium. 8. Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium. 9. Department of Pediatrics, University Hospital Brussels, Brussels, Belgium. 10. Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Louvain, Belgium. 11. Department of Nephrology, AZ Groeninge Hospital, Kortrijk, Belgium. 12. Division of Pathology, University Hospital Ghent, Ghent, Belgium. 13. Department of Nephrology and Dialysis, VITAZ Hospital, Sint-Niklaas, Belgium. 14. Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Louvain, Belgium. ben.sprangers@zol.be. 15. Division of Nephrology, University Hospitals Leuven, Louvain, Belgium. ben.sprangers@zol.be.
Abstract
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.
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.
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