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Böbrek Biyopsilerinin Klinikopatolojik Değerlendirmesi: Tek Merkez Deneyimi

Clinicopathological Evaluation of the Kidney Biopsies: Our Center’s Experience

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DOI: 
DOI 10.5262/tndt.2012.1002.11
Abstract (2. Language): 
OBJECTIVE S: Kidney biopsy is a valuable tool for both diagnosis and to guide treatment of renal diseases. In this report, we aimed both clinical and pathological evaluation of the kidney biopsies in our institution. MATER IAL and METHODS: Kidney biopsies in adult patients performed between 2002-2011 at the Department of Nephrology were analyzed. Biopsies were performed with the guidance of ultrasonography, and 16 and 18 G needles for two cores were used. At least seven glomeruli and one artery was accepted as adequate for diagnosis. RE SUL TS: Five hundred thirty six kidney biopsy reports was evaluated. The mean age of the patients at presentation was 42.80±16.66 years (16-85 years old), and 55.4% of the patients was male. The most frequent indication of the kidney biopsies were nephrotic range proteinuria with 63.43%. The most common histopathological diagnosis in primary and secondary glomerular diseases was membranous nephropathy (n=88, 16.4%) and amyloidosis (n=96, 17.9%) respectively. The most frequent diagnosis of the biopsies performed due to acute kidney injury was rapidly progressing glomerulonephritis (n=20, 3.7%). The major complication rate was low (0.18%). CONCLU SION: Nephrotic range proteinuria was the most frequent indication for the kidney biopsy in our institution. Membranous nephropathy and amyloidosis were the most frequent primary and secondary glomerular diseases. Complication rate in percutaneous kidney biopsy with the guidance of ultrasonography is low.
Abstract (Original Language): 
AMAÇ: Böbrek biyopsisi böbrek hastalıklarının tanısında ve tedavi yönetiminde yol gösterici bir yöntemdir. Çalışmamızda merkezimizde böbrek biyopsisi yapılan olguların klinik ve patolojik değerlendirmesi amaçlandı. GERE Ç ve YÖNTEMLER : Nefroloji Kliniği’nde 2002-2011 arasında erişkin grupta yapılan böbrek biyopsileri geriye dönük olarak değerlendirildi. Tüm biyopsiler ultrasonografi eşliğinde, iki kor örnek alınarak, 16 ve 18 G iğne kullanılarak yapıldı. En az 7 glomerül ve bir orta çaplı arter varlığı tanı için yeterli olarak kabul edildi. BUL GUL AR: Beş yüz otuz altı böbrek biyopsi sonucu değerlendirildi. Olguların ortalama yaşı 42.8±16.7 yıl (16-85 yıl), erkek cinsiyet %55,4 olarak hesaplandı. En sık böbrek biyopsi endikasyonu nefrotik düzeyde proteinüri %63,43 olarak saptandı. En sık karşılaşılan patolojik tanılar birincil ve ikincil glomerülonefrit olarak saptandı. En sık histopatolojik tanılar birincil glomerülonefritlerden membranöz nefropati (n=88, %16.4), ikincil glomerüler hastalıklardan amiloidozis (n=96, %17,9), akut böbrek hasarı nedeniyle yapılanlarda hızlı ilerleyen glomerülonefrit (n=20, %3,7) olarak saptandı. Majör komplikasyon sıklığı düşük (%0,18) olarak belirlendi. SONUÇ: Merkezimizde, böbrek biyopsisi yapılmasının en sık nedeni nefrotik düzeyde proteinüridir. Histopatolojik olarak en sık rapor edilen birincil glomerüler hastalık membranöz nefropati, ikincil glomerüler hastalık ise amiloidozisdir. Ultrasonografi eşliğinde yapılan perkütan böbrek biyopsisi komplikasyon oranı düşüktür.
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REFERENCES

References: 

1. Pirani CL: Evaluation of kidney biopsy specimens, In Tisher CG,
Brenner BM (eds): Renal Pathology: With Clinical and Functional
Correlations (2nd ed). Philadelphia, PA: Lippincott, 1994; 85-115
2. Fuiano G, Mazza G, Comi N, Caglioti A, De Nicola L, Iodice C,
Andreucci M, Andreucci VE: Current indications for renal biopsy:
A questionnaire-based survey. Am J Kidney Dis 2000; 35 (3):
448-457
3. Önen K: Böbrek hastalıklarının tanısı. Klinik Nefroloji. Çağlar Ş
(ed). Ankara: Medial, 1986: 57-99
4. Topham PS, Chen Y: Renal Biopsy, in Floege J, Johnson RJ,
Feehally J (eds), Comprehensive Clinical Nephrology (4th ed).
Elsevier, 2010; 75-82
5. Rivera F, López-Gómez JM, Pérez-García R; Spanish Registry of
glomerulonephritis: Frequency of renal pathology in Spain 1994-
1999. Nephrol Dial Transplant 2002; 17 (9): 1594-1602
6. Rychlík I, Jancová E, Tesar V, Kolsky A, Lácha J, Stejskal J,
Stejskalová A, Dusek J, Herout V: The Czech registry of renal
biopsies. Occurrence of renal diseases in the years 1994-2000.
Nephrol Dial Transplant 2004; 19 (12): 3040-3049
7. Schena FP: Survey of the Italian registry of renal biopsies.
Frequency of the renal diseases for 7 consecutive years. The Italian
Group of Renal Immunopathology. Nephrol Dial Transplant 1997;
12 (3): 418-426
8. Heaf J, Løkkegaard H, Larsen S: The epidemiology and prognosis
of glomerulonephritis in Denmark 1985-1997. Nephrol Dial
Transplant 1999; 14 (8): 1889-1897
9. Bellomo R, Ronco C, Kellum JA, Mehta RL, Palevsky P; Acute
Dialysis Quality Initiative Workgroup: Acute renal failure -
definition, outcome measures, animal models, fluid therapy and
information technology needs: The Second International Consensus
Conferenceof the Acute Dialysis Quality Initiative (ADQI) Group.
Crit Care 2004; 8 (4): R204-212
10. National Kidney Foundation: K/DOQI clinical practice guidelines
for chronic kidney disease: Evaluation, classification and
stratification. National Kidney Foundation. Am J Kidney Dis 2002;
39 (2 Suppl 1): S1-266
11. Richards NT, Darby S, Howie AJ, Adu D, Michael J: Knowledge
of renal histology alters patient management in over 40% of cases.
Nephrol Dial Transplant 1994; 9 (9): 1255-1259
12. Eiro M, Katoh T, Watanabe T: Risk factors for bleeding complications
in percutaneous renal biopsy. Clin Exp Nephrol 2005; 9 (1): 40-45
13. Hergesell O, Felten H, Andrassy K, Kühn K, Ritz E: Safety of
ultrasound-guided percutaneous renal biopsy-retrospective analysis
of 1090 consecutive cases. Nephrol Dial Transplant 1998; 13 (4):
975-977
14. Manno C, Strippoli GF, Arnesano L, Bonifati C, Campobasso N,
Gesualdo L, Schena FP: Predictors of bleeding complications in
percutaneous ultrasound-guided renal biopsy. Kidney Int 2004; 66
(4): 1570-1577
15. Sayarlıoğlu H, Erkoç R, Topal C, Doğan E, Özen S, Bayram İ,
Uğraş S: Epidemiology of glomerulonephritis in the City of Van:
Pathological findings of 129 cases. Turk Neph Dial Transpl 2005;
14 (1): 23-25
16. Ecder SA, Kılıçaslan I, Ecder T, Türkmen A, Özağarı A, Uysal V,
Sever MŞ: Beşyüz onüç böbrek biyopsisinin klinikopatolojik açıdan
değerlendirmesi. İst Tıp Fak Derg 2005; 68: 43-45
17. Hur E, Taskin H, Bozkurt D, Sarsik B, Sen S, Ertilav M, Sipahi S,
Basci A, Akcicek F, Duman S: Adult native renal biopsy experience
of Ege University for 12 consecutive years. BANTAO Journal
2010; 8 (1): 22-29
18. Gesualdo L, Di Palma AM, Morrone LF, Strippoli GF, Schena FP:
Italian Immunopathology Group, Italian Society of Nephrology:
The Italian experience of the national registry of renal biopsies.
Kidney Int 2004; 66 (3): 890-894
19. Simon P, Ramee MP, Boulahrouz R, Stanescu C, Charasse C,
Ang KS, Leonetti F, Cam G, Laruelle E, Autuly V, Rioux N:
Epidemiologic data of primary glomerular diseases in Western
France. Kidney Int 2004; 66 (3): 905-908
20. Sipiczki T, Ondrik Z, Abrahám G, Pokorny G, Túri S, Sonkodi S,
Kemény E, Iványi B: The incidence of renal diseases as diagnosed
by biopsy in Hungary. Orv Hetil 2004; 145 (26): 1373-1379
21. Polenakovic MH, Grcevska L, Dzikova S: The incidence of biopsyproven
primary glomerulonephritis in the Republic of Macedonialong-
term follow-up. Nephrol Dial Transplant 2003; 18 Suppl 5:
26-27
22. Covic A, Schiller A, Volovat C, Gluhovschi G, Gusbeth-Tatomir P,
Petrica L, Caruntu ID, Bozdog G, Velciov S, Trandafirescu V, Bob
F, Gluhovschi C: Epidemiology of renal disease in Romania: A 10
year review of two regional renal biopsy databases. Nephrol Dial
Transplant 2006; 21 (2): 419-424
23. Naumovic R, Pavlovic S, Stojkovic D, Basta-Jovanovic G, Nesic
V: Renal biopsy registry from a single centre in Serbia: 20 years of
experience. Nephrol Dial Transplant 2009; 24 (3): 877-885
24. Nair R, Walker PD: Is IgA nephropathy the commonest primary
glomerulopathy among young adults in the USA? Kidney Int 2006;
69 (8): 1455-1458
25. Swaminathan S, Leung N, Lager DJ, Melton LJ 3rd, Bergstralh
EJ, Rohlinger A, Fervenza FC: Changing incidence of glomerular
disease in Olmsted County, Minnesota: A 30-year renal biopsy
study. Clin J Am Soc Nephrol 2006; 1 (3): 483-487
26. Polito MG, de Moura LA, Kirsztajn GM: An overview on frequency
of renal biopsy diagnosis in Brazil: Clinical and pathological
patterns based on 9,617 native kidney biopsies. Nephrol Dial
Transplant 2010; 25 (2): 490-496
27. Li LS, Liu ZH: Epidemiologic data of renal diseases from a single
unit in China: Analysis based on 13.519 renal biopsies. Kidney Int
2004; 66 (3): 920-923
28. Nationwide and long-term survey of primary glomerulonephritis
in Japan as observed in 1,850 biopsied cases. Research Group on
Progressive Chronic Renal Disease. Nephron 1999; 82 (3): 205-213
29. Chang JH, Kim DK, Kim HW, Park SY, Yoo TH, Kim BS, Kang
SW, Choi KH, Han DS, Jeong HJ, Lee HY: Changing prevalence
of glomerular diseases in Korean adults: A review of 20 years of
experience. Nephrol Dial Transplant 2009; 24 (8): 2406-2410
30. Huraib S, Al Khader A, Shaheen FA, Abu Aisha H, Souqiyyeh MZ,
Al Mohana F, Soliman M, Al Wakeel J, Mitwalli A, Al Mohaya S,
Said R, Abdulhaleem Al, Menawy L, Sohaibani M, Chan N: The
spectrum of glomerulonephritis in Saudi Arabia: The results of the
Saudi registry. Saudi J Kidney Dis Transpl 2000; 11 (3): 434-441
31. Schwimmer JA, Joseph RE, Appel GB: Amyloid, fibrillary, and the
glomerular deposition diseases in therapy. In Wilcox CS, Brady HR
(eds), Nephrology and Hypertension. Philadelphia: Saunders, 2003;
253-261
32. Falk RH, Skinner M: The systemic amyloidoses: An overview. Adv
Intern Med 2000; 45: 107-137
33. Tuglular S, Yalcinkaya F, Paydas S, Oner A, Utas C, Bozfakioglu
S, Ataman R, Akpolat T, Ok E, Sen S, Düsünsel R, Evrenkaya
R, Akoglu E: A retrospective analysis for aetiology and clinical
findings of 287 secondary amyloidosis cases in Turkey. Nephrol
Dial Transplant 2002; 17 (11): 2003-2005
34. Ensari C, Ensari A, Tümer N, Ertug E: Clinicopathological and
epidemiological analysis of amyloidosis in Turkish patients.
Nephrol Dial Transplant 2005; 20 (8): 1721-1725
35. Paydas S: Report on 59 patients with renal amyloidosis. Int Urol
Nephrol 1999; 31 (5): 619-631
36. Lachmann HJ, Goodman HJ, Gilbertson JA, Gallimore JR, Sabin
CA, Gillmore JD, Hawkins PN: Natural history and outcome in
systemic AA amyloidosis. N Engl J Med 2007; 356: 2361-2371
37. Verine J, Mourad N, Desseaux K, Vanhille P, Noël LH, Beaufils H,
Grateau G, Janin A, Droz D: Clinical and histological characteristics
of renal AA amyloidosis: A retrospective study of 68 cases with a
special interest to amyloid-associated inflammatory response. Hum
Pathol 2007; 38 (12): 1798-1809
38. Oğuz Y, Dede F, Ay AS, Karaman M, Eyileten T, Kırkpantur A,
Yılmaz MI: Renal Biopsy in patients aged 65 years and older: A
clinicopathological analysis. Turk Neph Dial Transpl 2010; 19 (3):
174-179
39. Haas M, Spargo BH, Wit Emst-Jan C, Meehan SM: Etiologies and
outcome of acute renal insufficiency in older adults: A renal biopsy
study of 259 cases. Am J Kidney Dis 2000; 35 (3): 433-447
40. Uezono S, Hara S, Sato Y, Komatsu H, Ikeda N, Shimao Y, Hayashi
T, Asada Y, Fujimoto S, Eto T: Renal biopsy in elderly patients: A
clinicopathological analysis. Ren Fail 2006; 28 (7): 549-555
41. Moutzouris DA, Herlitz L, Appel GB, Markowitz GS, Freudenthal
B, Radhakrishnan J, D’Agati VD: Renal biopsy in the very elderly.
Clin J Am Soc Nephrol 2009; 4 (6): 1073-1082

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