Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-77c89778f8-m8s7h Total loading time: 0 Render date: 2024-07-21T19:56:03.872Z Has data issue: false hasContentIssue false

Chapter 2 - Distribution of Pediatric Renal Biopsy Diagnoses in a Large Single Center and Rare Pediatric Cases

from Section 1 - Normal and Abnormal Human Kidney Development

Published online by Cambridge University Press:  10 August 2023

By
Alejandro Best Rocha
Edited by
Helen Liapis
Helen Liapis
Affiliation:
Ludwig Maximilian University, Nephrology Center, Munich, Adjunct Professor and Washington University St Louis, Department of Pathology and Immunology, Retired Professor
Get access

Summary

The distribution of renal disease varies significantly between the adult and pediatric population. Furthermore, given the advances in the understanding of renal diseases, the manner in which diseases are categorized and diagnosed has evolved over time. To study an up-to-date distribution of pediatric renal diseases, a retrospective review of all biopsy reports from patients between birth and 18 years of age, diagnosed at a central reference laboratory over a 5-year period (2016–2020), was performed. A total of 3,606 pediatric biopsies were reviewed, representing 4.63% of all samples (total: 77,941). Biopsies from native kidneys equaled 2,880, while those from allografts totaled 726. In native kidneys, glomerular diseases represented the overwhelming majority of diagnoses (76.6%), followed by tubulointerstitial diseases (15.65), normal biopsies (8.09%), limited samples (2.92%), non-specific chronic changes (2.74%), vascular diseases (1.8%), monoclonal immunoglobulin-related disease (0.17%) and, lastly, malignant infiltrating diseases (0.1%). On the other hand, allograft biopsies predominantly showed rejection (49.31%), either T-cell-mediated, antibody-mediated or a combination of both, followed by negative for rejection (46.42%) and limited samples (4.27%). Biopsies categorized as negative for rejection included acute tubular injury (17.77%), infarcts (0.41%), recurrent diseases (4.27%), de novo diseases (6.34%), polyomavirus nephropathy (2.75%) and normal histology (14.88%).

Keywords

Biopsy incidence of renal diseasesglomerular diseasetubulointerstitial diseaseallograft biopsies in children
Type
Chapter
Information
Pediatric Nephropathology & Childhood Kidney Tumors , pp. 17 - 26
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Coppo, R., Gianoglio, B., Porcellini, M. G., Maringhini, S.. Frequency of renal diseases and clinical indications for renal biopsy in children (Report of the Italian National Registry of Renal Biopsies in Children). Nephrol Dial Transplant 1998; 13: 293–7.Google Scholar
Hussain, F., Mallik, M., Marks, S. D., Watson, A. R.. Renal biopsies in children: Current practice and audit of outcomes. Nephrol Dial Transplant 2010; 25: 485–9.CrossRefGoogle ScholarPubMed
O’Shaughnessy, M. M., Hogan, S. L., Poulton, C. J., Falk, R. J., Singh, H. K., Nickeleit, V., et al. Temporal and demographic trends in glomerular disease epidemiology in the southeastern United States, 1986–2015. Clin J Am Soc Nephrol 2017; 12: 614–23.CrossRefGoogle ScholarPubMed
Kawasaki, Y., Kanno, S., Ono, A., Suzuki, Y., Ohara, S., Sato, M., et al. Differences in clinical findings, pathology, and outcomes between C3 glomerulonephritis and membranoproliferative glomerulonephritis. Pediatr Nephrol 2016; 31: 1091–9.CrossRefGoogle ScholarPubMed
Bajema, I. M., Wilhelmus, S., Alpers, C. E., Bruijn, J. A., Colvin, R. B., Cook, H. T., et al. Revision of the International Society of Nephrology/Renal Pathology Society classification for lupus nephritis: clarification of definitions, and modified National Institutes of Health activity and chronicity indices. Kidney Int 2018; 93: 789–96.Google Scholar
Sethi, S., Zand, L., Nasr, S. H., Glassock, R. J., Fervenza, F. C.. Focal and segmental glomerulosclerosis: Clinical and kidney biopsy correlations. Clin Kidney J 2014; 7: 531–7.Google Scholar
Southwest Nephrology Study Group. Childhood nephrotic syndrome associated with diffuse mesangial hypercellularity. A report of the Southwest Pediatric Nephrology Study Group. Kidney Int 1983; 24: 87–94.Google Scholar
Kopp, J. B., Nelson, G. W., Sampath, K., Johnson, R. C., Genovese, G., An, P., et al. APOL1 genetic variants in focal segmental glomerulosclerosis and HIV-associated nephropathy. J Am Soc Nephrol 2011; 22: 2129–37.CrossRefGoogle ScholarPubMed
Larsen, C. P., Beggs, M. L., Saeed, M., Walker, P. D.. Apolipoprotein L1 risk variants associate with systemic lupus erythematosus-associated collapsing glomerulopathy. J Am Soc Nephrol 2013; 24: 722–5.Google Scholar
Abid, Q., Best Rocha, A., Larsen, C. P., Schulert, G., Marsh, R., Yasin, S., et al. APOL1-associated collapsing focal segmental glomerulosclerosis in a patient with stimulator of interferon genes (STING)-associated vasculopathy with onset in infancy (SAVI). Am J Kidney Dis 2020; 75: 287–90.Google Scholar
Velez, J. C. Q., Caza, T., Larsen, C. P.. COVAN is the new HIVAN: the re-emergence of collapsing glomerulopathy with COVID-19. Nat Rev Nephrol 2020; 16: 565–7.Google Scholar
Lipska, B. S., Ranchin, B., Iatropoulos, P., Gellermann, J., Melk, A., Ozaltin, F., et al. Genotype-phenotype associations in WT1 glomerulopathy. Kidney Int 2014; 85: 1169–78.CrossRefGoogle ScholarPubMed
Larsen, C. P., Messias, N. C., Silva, F. G., Messias, E., Walker, P. D.. Determination of primary versus secondary membranous glomerulopathy utilizing phospholipase A2 receptor staining in renal biopsies. Mod Pathol 2013; 26: 709–15.CrossRefGoogle ScholarPubMed
Cossey, L. N., Walker, P. D., Larsen, C. P.. Phospholipase A2 receptor staining in pediatric idiopathic membranous glomerulopathy. Pediatr Nephrol 2013; 28: 2307–11.CrossRefGoogle ScholarPubMed
Sethi, S., Madden, B. J., Debiec, H., Charlesworth, M. C., Gross, L., Ravindran, A., et al. Exostosin 1/Exostosin 2-associated membranous nephropathy. J Am Soc Nephrol 2019; 30: 1123–36.Google Scholar
Caza, T. N., Hassen, S. I., Dvanajscak, Z., Kuperman, M., Edmondson, R., Herzog, C., et al. NELL1 is a target antigen in malignancy-associated membranous nephropathy. Kidney Int 2021; 99: 967–76.Google Scholar
Larsen, C. P., Ambruzs, J. M., Bonsib, S. M., Boils, C. L., Cossey, L. N., Messias, N. C., et al. Membranous-like glomerulopathy with masked IgG kappa deposits. Kidney Int 2014; 86: 154–61.CrossRefGoogle ScholarPubMed
Larsen, C. P., Sharma, S. G., Caza, T. N., Kenan, D. J., Storey, A. J., Edmondson, R. D., et al. Serum amyloid P deposition is a sensitive and specific feature of membranous-like glomerulopathy with masked IgG kappa deposits. Kidney Int 2020; 97: 602–8.Google Scholar
Kashtan, C. E., Ding, J., Garosi, G., Heidet, L., Massella, L., Nakanishi, K., et al. Alport syndrome: a unified classification of genetic disorders of collagen IV α345: A position paper of the Alport Syndrome Classification Working Group. Kidney Int 2018; 93: 1045–51.Google Scholar
Savige, J., Colville, D., Rheault, M., Gear, S., Lennon, R., Lagas, S., et al. Alport syndrome in women and girls. Clin J Am Soc Nephrol 2016; 11: 1713–20.CrossRefGoogle ScholarPubMed
Cohen Tervaert, T. W., Mooyaart, A. L., Amann, K., Cohen, A. H., Cook, H. T., Drachenberg, C. B., et al. Pathologic classification of diabetic nephropathy. J Am Soc Nephrol 2010; 21: 556–63.Google Scholar
Liapis, H., Boils, C., Hennigar, R., Silva, F.. Myoglobin casts in renal biopsies: Immunohistochemistry and morphologic spectrum. Hum Pathol 2016; 54: 25–30.Google Scholar
Dvanajscak, Z., Walker, P. D., Cossey, L. N., Messias, N. C., Boils, C. L., Kuperman, M. B., et al. Hemolysis-associated hemoglobin cast nephropathy results from a range of clinicopathologic disorders. Kidney Int 2019; 96: 1400–7.CrossRefGoogle ScholarPubMed
Sindhar, S., Lugo, M., Levin, M. D., Danback, J. R., Brink, B. D., Yu, E., et al. Hypercalcemia in patients with Williams-Beuren Syndrome. J Pediatr 2016; 178: 254–60.CrossRefGoogle ScholarPubMed
Larsen, C. P., Bonsib, S. M., Beggs, M. L., Wilson, J. D.. Fluorescence in situ hybridization for the diagnosis of NPHP1 deletion-related nephronophthisis on renal biopsy. Hum Pathol 2018; 81: 71–7.Google Scholar
Leung, N., Bridoux, F., Batuman, V., Chaidos, A., Cockwell, P., D’Agati, V., et al. The evaluation of monoclonal gammopathy of renal significance: A consensus report of the International Kidney and Monoclonal Gammopathy Research Group. Nat Rev Nephrol 2019; 15: 45–59.Google Scholar
Nasr, S. H., Satoskar, A., Markowitz, G. S., Valeri, A. M., Appel, G. B., Stokes, M. B., et al. Proliferative glomerulonephritis with monoclonal IgG deposits. J Am Soc Nephrol 2009; 20: 2055–64.Google Scholar
Xing, G., Gillespie, R., Bedri, B., Quan, A., Zhang, P.. Proliferative glomerulonephritis with monoclonal IgG deposits in children and young adults. Pediatr Nephrol 2018; 33: 1531–8.Google Scholar
Loupy, A., Haas, M., Roufosse, C., Naesens, M., Adam, B., Afrouzian, M., et al. The Banff 2019 Kidney Meeting Report (I): Updates on and clarification of criteria for T cell- and antibody-mediated rejection. Am J Transplant 2020; 20: 2318–31.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×