An Analysis of 3,000 Cases of Percutaneous Renal Biopsy: Single Center Study / 대한신장학회지

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.

Peritonitis by Chryseobacterium indologenes and Sphingomonas paucimobilis in a Patient Undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) / 대한신장학회지

Bacterial peritonitis is a well-recognized complication of continuous ambulatory peritoneal dialysis (CAPD) in patients with end-stage renal failure. Chryseobacterium indologenes is a non-fermentative Gram-negative bacillus that is a rare pathogen in humans and Sphinomomas paucimobilis has rarely been reported as an opportunistic human pathogen. We present a case of peritonitis due to unusual pathogens, C. indologenes and S. paucimobilis, unresponsive to the standard antibiotics therapy. A 51-year-old diabetic man undergoing CAPD for 45 days developed the first peritonitis due to C. indolegenes. Although he had received intraperitoneal antibiotics with good in vitro activity against organism, the signs of peritonitis persisted. S. paucimobilis was isolated from dialysate sample. The Tenckhoff catheter was finally removed on 19th day of hospitalization and the fever and abdominal pain subsided.