Abstract | Cilj: Cilj je bio istražiti raspodjelu patohistoloških nalaza bubrežnih bioptata u prvih 300 bubrežnih biopsija (BB) učinjenih u Kliničkom bolničkom centru Osijek (KBCO) otkako se tamo vrše takvi postupci, od 2009. do 2017. godine. Nacrt istraživanja: Istraživanje je bilo presječno. Ispitanici i metode: Uključeno je 304 bubrežna bioptata (62,2 % u muškaraca, medijana dobi 52 godine, interkvartilni raspon 44 – 62). Podatci o dobi i spolu bioptiranih bolesnika, podrijetlu bubrega (nativan ili presađen), godini učinjene biopsije, serumskom kreatininu, glomerulskoj filtraciji, nalazu sedimenta mokraće, 24-satnoj proteinuriji, indikacijama za BB i patohistološkim nalazima prikupljeni su iz medicinskih zapisa i analizirani statistički u SPSS-u (inačica 21.0, SPSS Inc., Chicago, IL, USA). Rezultati: Bioptirani bubrezi najčešće su bili nativni, u 74,3 % slučajeva. Najčešće indikacije za BB bile su nefrotički sindrom (u 25,1 %), kronički nefritički sindrom (16,7 %) i zatajenje bubrežnog presatka (8,7 %), koji je ujedno bila i najčešća indikacija u bolesnika s bubrežnim presatkom (34,2 %). Najčešće primarne konačne patohistološke dijagnoze (za sve bioptate) bile su IgA nefropatija (13,8 %), pauci-imuni glomerulonefritis (6,4 %), nasljedni nefritis i fokalna segmentalna glomeruloskleroza (6 %) i membranski glomerulonefritis i glomerulonefritis povezan s bolestima vezivnog tkiva (oba s po 5 %). U transplantiranih bubrega najčešće je nađeno akutno odbacivanje posredovano limfocitima T (16 %) i kombinirano odbacivanje – stanično i posredovano protutijelima (16 %). Zaključak: Raspodjela patohistoloških nalaza u bubrežnim bioptatima u KBCO bila je slična onima u oskudnim objavljenim podatcima za uzorke hrvatske populacije. Ovi rezultati mogu poslužiti kao baza budućeg institucijskog ili nacionalnog registra BB-a. |
Abstract (english) | Objective: The aim of the study was to investigate the distribution of histopathological findings of kidney biopsy (KB) in the first 300 KBs done at University Hospital Center Osijek (UHCO), since the introduction of the procedure in 2009 until 2017. Study design: The study was cross-sectional. Participants and Methods: In the 304 KBs (62.2% in men, median age 52 years, interquartile range 44 – 62) data on age and gender of biopsied patients, renal origin (native or transplanted), year of biopsy, serum creatinine, glomerular filtration, urinary sediment, 24-hour proteinuria, KB indications and pathohistological findings were collected from the medical records and analyzed statistically in SPSS (version 21.0, SPSS Inc., Chicago, IL, USA). Results: Biopted kidneys were most commonly native, in 74.3% of cases. The most common indication for KB was nephrotic syndrome (25.1%), chronic nephritic syndrome (16.7%), and failure after kidney transplantation (8.7%), which was also the most frequent indication for patients with renal transplant (34.2%). Most common primary final histopathological diagnoses (for all biopsies) were IgA nephropathy (13.8%), pauci-immune glomerulonephritis (6.4%), hereditary nephritis and focal segmental glomerulosclerosis (both at 6%, resp.), and membranous glomerulonephritis and glomerulonephritis associated with connective tissue diseases (both at 5%, resp.). The transplanted kidney primary final histopathological diagnosis was acute T-cell mediated rejection and combined rejection – T-cell and antibody mediated (both at 16%, resp.). Conclusion: The distribution of histopathological findings in renal biopsy in UHCO was similar to those in scarce published data for the Croatian population. These data may serve as a basis for a future institutional or national KB register. |