Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Pinter, K.
The acute/rapidly-progressive nephritic syndrome in Europe_x000D_-a retrospective study.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 101
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Goritschan Anna
- Rosenkranz Alexander
- Altmetrics:
- Abstract:
- Introduction: Renal biopsy registries can establish incidence, prevalence and demographic differences of renal diseases and assist in diagnosis, prognosis and ultimately therapy. In Europe various renal biopsy registries exist. Incidence and prevalence are not only influenced by genetic and environmental differences, but also alter depending on biopsy indication in each country, region and center. In this study we describe the establishment of a renal biopsy registry at the Medical University of Graz, and evaluate regional prevalence, demographic differences and clinical data in patients with proliferative glomerulopathies. Methods: Between 2007 and 2017 patients who underwent renal biopsy were evaluated and transferred in a newly developed registry. In addition, epidemiological and clinical data as well as various immunological and non-immunological laboratory data, at the time the patient underwent biopsy, were gathered. Creatinine values were followed over a period of 5 years. At last we evaluated complications following renal biopsies. Results: A total of 973 renal biopsies were performed. Thereof 419 biopsies were performed in patients with a renal allograft. Of the 554 native biopsies, repeated biopsies, not representative biopsies, and biopsies with missing patient information were excluded. A total 506 native renal biopsies were evaluated with 238 biopsies being categorized as proliferative glomerulopathies. The most common proliferative glomerulopathy were IgA nephropathy (12,3 %), lupus nephritis (12,1%), PR3-ANCA associated glomerulonephritis (6,3%) and MPO-ANCA associated glomerulonephritis (5,9%). In IgA nephropathy, when T-score (MEST-classification) was T1 or T2, which was more often seen in men (51,6% vs. 13,4%), serum-creatinine was higher (T1: 2,8mg/dl; T2: 4,4mg/dl) compared to T0 (1,9mg/dl) and was associated with worse outcomes (ESKD or death) in the follow up (T1: 50,0%; T2: 100,0%; T0:8,7%). Interestingly, female patients with MPO-ANCA associated glomerulonephritis were 15 years older than female patients with PR3-ANCA associated glomerulonephritis (68a±10a vs. 53a±15a, p=0,002). No significant age difference in ANCA associated glomerulonephritis was found in men. More patients PR3-ANCA associated glomerulonephritis required plasmapheresis and renal replacement therapy (RRT) than patients with MPO-ANCA associated glomerulonephritis (Plasmapheresis: 46,9% vs. 36,7% and RRT: 40,6% vs. 20%). No patient with ANCA negative glomerulonephritis required either plasmapheresis or renal replacement therapy. Conclusion: In addition to a noticeable age difference in female patients with ANCA-associated glomerulonephritis, a comparison across Europe showed that, IgA nephropathy was the most common primary glomerulopathy in our cohort. This is true for most other European countries. Universal terminology can not only help understanding disease process but is essential when conducting epidemiological studies.