Perkowska-Ptasinska Agnieszka, Bartczak Artur, Wagrowska-Danilewicz Malgorzata, Halon Agnieszka, Okon Krzysztof, Wozniak Aldona, Danilewicz Marian, Karkoszka Henryk, Marszalek Andrzej, Kowalewska Jolanta, Mroz Andrzej, Korolczuk Agnieszka, Oko Andrzej, Debska-Slizien Alicja, Naumnik Beata, Hruby Zbigniew, Klinger Marian, Ciechanowski Kazimierz, Myslak Marek, Sulowicz Wladyslaw, Rydzewski Andrzej, Wiecek Andrzej, Manitius Jacek, Gregorczyk Tadeusz, Niemczyk Stanislaw, Nowicki Michal, Gellert Ryszard, Stompor Tomasz, Wieliczko Monika, Marczewski Krzysztof, Paczek Leszek, Rostkowska Olga, Deborska-Materkowska Dominika, Bogdanowicz Grazyna, Milkowski Andrzej, Durlik Magdalena
Department of Transplantology, Nephrology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.
Department of Pathology, Medical Center of Postgraduate Education, Warsaw, Poland.
Nephrol Dial Transplant. 2017 Apr 1;32(suppl_2):ii209-ii218. doi: 10.1093/ndt/gfw365.
This is the first report on the epidemiology of biopsy-proven kidney diseases in Poland.
The Polish Registry of Renal Biopsies has collected information on all (n = 9394) native renal biopsies performed in Poland from 2009 to 2014. Patients' clinical data collected at the time of biopsy, and histopathological diagnoses were used for epidemiological and clinicopathologic analysis.
There was a gradual increase in the number of native renal biopsies performed per million people (PMP) per year in Poland in 2009-14, starting from 36 PMP in 2009 to 44 PMP in 2014. A considerable variability between provinces in the mean number of biopsies performed in the period covered was found, ranging from 5 to 77 PMP/year. The most common renal biopsy diagnoses in adults were immunoglobulin A nephropathy (IgAN) (20%), focal segmental glomerulosclerosis (FSGS) (15%) and membranous glomerulonephritis (MGN) (11%), whereas in children, minimal change disease (22%), IgAN (20%) and FSGS (10%) were dominant. Due to insufficient data on the paediatric population, the clinicopathologic analysis was limited to patients ≥18 years of age. At the time of renal biopsy, the majority of adult patients presented nephrotic-range proteinuria (45.2%), followed by urinary abnormalities (38.3%), nephritic syndrome (13.8%) and isolated haematuria (1.7%). Among nephrotic patients, primary glomerulopathies dominated (67.6% in those 18-64 years of age and 62.4% in elderly patients) with leading diagnoses being MGN (17.1%), FSGS (16.2%) and IgAN (13.0%) in the younger cohort and MGN (23.5%), amyloidosis (18.8%) and FSGS (16.8%) in the elderly cohort. Among nephritic patients 18-64 years of age, the majority (55.9%) suffered from primary glomerulopathies, with a predominance of IgAN (31.3%), FSGS (12.7%) and crescentic GN (CGN) (11.1%). Among elderly nephritic patients, primary and secondary glomerulopathies were equally common (41.9% each) and pauci-immune GN (24.7%), CGN (20.4%) and IgAN (14.0%) were predominant. In both adult cohorts, urinary abnormalities were mostly related to primary glomerulopathies (66.8% in younger and 50% in elderly patients) and the leading diagnoses were IgAN (31.4%), FSGS (15.9%), lupus nephritis (10.7%) and FSGS (19.2%), MGN (15.1%) and pauci-immune GN (12.3%), respectively. There were significant differences in clinical characteristics and renal biopsy findings between male and female adult patients.
The registry data focused new light on the epidemiology of kidney diseases in Poland. These data should be used in future follow-up and prospective studies.
这是关于波兰经活检证实的肾脏疾病流行病学的首份报告。
波兰肾脏活检登记处收集了2009年至2014年在波兰进行的所有（n = 9394例）自体肾活检的信息。活检时收集的患者临床数据以及组织病理学诊断结果用于流行病学和临床病理分析。
2009 - 2014年波兰每年每百万人口（PMP）进行的自体肾活检数量逐渐增加，从2009年的36 PMP增至2014年的44 PMP。在所涵盖的时期内，各省份活检平均数量存在显著差异，范围为每年5至77 PMP。成人中最常见的肾活检诊断为免疫球蛋白A肾病（IgAN）（20%）、局灶节段性肾小球硬化（FSGS）（15%）和膜性肾小球肾炎（MGN）（11%），而儿童中，微小病变病（22%）、IgAN（20%）和FSGS（10%）占主导。由于儿科人群数据不足，临床病理分析仅限于年龄≥18岁的患者。在肾活检时，大多数成年患者表现为肾病范围蛋白尿（45.2%），其次是尿液异常（38.3%）、肾炎综合征（13.8%）和单纯血尿（1.7%）。在肾病患者中，原发性肾小球病占主导（18 - 64岁患者中占67.6%，老年患者中占62.4%），年轻队列中主要诊断为MGN（17.1%）、FSGS（16.2%）和IgAN（13.0%），老年队列中为MGN（23.5%）、淀粉样变性（18.8%）和FSGS（16.8%）。在18 - 64岁的肾炎患者中，大多数（55.9%）患有原发性肾小球病，以IgAN（31.3%）、FSGS（12.7%）和新月体性肾小球肾炎（CGN）（11.1%）为主。在老年肾炎患者中，原发性和继发性肾小球病同样常见（各占41.9%），寡免疫性肾小球肾炎（24.7%）、CGN（20.4%）和IgAN（14.0%）占主导。在两个成年队列中，尿液异常大多与原发性肾小球病相关（年轻患者中占66.8%，老年患者中占50%），主要诊断分别为IgAN（31.4%）、FSGS（15.9%）、狼疮性肾炎（10.7%）以及FSGS（19.2%）、MGN（15.1%）和寡免疫性肾小球肾炎（12.3%）。成年男性和女性患者在临床特征和肾活检结果方面存在显著差异。
登记处数据为波兰肾脏疾病的流行病学研究提供了新的视角。这些数据应在未来的随访和前瞻性研究中加以应用。
