Clinical and Histopathological Analysis of 494 Cases of Percutaneous Renal Biopsies / 대한신장학회잡지

Percutaneous renal biopsy is an essential component for diagnosis and management of glomerular diseases. In order to elucidate clinical and pathological features, 494 renal patients who had undergone renal biopsies at Gil Medical Center from January 1989 to June 1999 were studied retrospectively. The male to female ratio was 1.3 : 1 and average age was 33.2 years. There were 370(83.5%) cases of primary glomerular disease and 58(13.1%) cases of secondary glomerular disease. Among primary glomerular disease, IgA nephropathy was the most common(175 cases), followed by minimal change disease(84 cases), membranous glomerulonephritis(34 cases), and focal segmental glomerulosclerosis(33 cases). In secondary glomerular disease, lupus nephritis was the most common(21 cases), followed by 11 cases of hepatitis B associated glomerulonephritis, 9 cases of Henoch-Sch nlein purpura, and 4 cases of diabetic nephropathy. Among 99 cases of asymptomatic urinary abnormalities, IgA nephropathy was most common(69 cases) followed by 12 cases of thin basement membrane disease, 4 cases of minimal change disease, and 3 cases of focal segmental glomerulosclerosis, membranous glomerulonephritis, nonspecific glomerulonephritis. Among 159 cases of nephrotic syndrome, minimal change disease was most common(60 cases) followed by 25 cases of IgA nephropathy, 23 cases of focal segmental glomerulosclerosis, 21 cases of membranous glomerulonephritis, and 13 cases of lupus nephritis. Documented complication of renal biopsies included 23 cases of gross hematuria, 6 cases of perirenal hematoma, and 4 cases of infection. Death, AV fistula, aneurysm or serious compications that required surgical intervention were not reported. In conclusion, the percutaneous renal biopsy is relatively safe, and useful for diagnosis and management of glomerular diseases. The most common type of primary glomerular disease was IgA nephropathy.

Clinicopathologic Studies of Asymptornatic Urinary Abnormalities / 대한신장학회잡지

Asymptomatic urinary abnormalities are one of the most frequent abnormalities in clinical nephrology. Between April 1981 and February 1999, we conducted retrospective follow-up studies of 159 patients with asymptomatic urinary abnormality that was proven by kidney biopsy, and evaluated their histologic findings and natural course. Mean age was 34.7 years old and sex ratio of male to female was 78: 81. They were divided into three groups according to the initial urinalysis findings' six patients with isolated hematuria, 33 patients with isolated proteinuria, and 120 patients with concomitant hematuria and proteinuria. The mean follow-up period was 35.5+/-30.5 months. In pathologic findings, 95 cases(59.3%) had IgA nephropathy, 27 cases(17.5%) had minor lesion, 12 cases(7.5%) showed focal and segmental glomerulo- sclerosis, 10 cases(6.3%) had membrannvs glomer-ulonephritis, 9 cases(5.6%) had mesangial prolifera- tive glomerulonephritis. Amyloidosis and thin base-ment membrane disease were seen in two cases, respectively. There were no specific correlations between morphologic patterns and degree of proteinuria. During the mean follow-up period, hematuria or proteinuria disppeared in 14%, persisted in 49%, and developed renal insufficiency in 21%. During the mean follow-up period, isolated proteinuria disappeared in 24%, persisted in 36%, and developed renal insufficiency in 21%. We conclude that the most common cause of asymptomatic urinary abnormalities was IgA nephropathy and early diagnosis through renal biopsy and management is needed to prevent or slow the progression to chronic renal failure.