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      Patterns of renal disease in South Korea: a 20-year review of a single-center renal biopsy database

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          Abstract

          Background: Several registries and centers have reported the results of renal biopsies from different parts of the world. As there are few data regarding the epidemiology of glomerulonephritis (GN) in South Korea, we conducted this study on renal biopsy findings during the last 20 years from a single center.

          Methods: Data for 818 patients who underwent renal biopsy at our center between 1992 and 2011 were collected retrospectively. All kidney specimens were examined with light microscopy (LM) and immunofluorescent microscopy (IF).

          Results: There were 818 cases of native kidney biopsies. In cases of primary GN, the most frequent type of renal pathology in adults (18–59 years) was mesangial proliferative GN (MsPGN, 34.5%) followed by IgA nephropathy (IgAN, 33.3%) and membranous GN (MGN, 8.8%). Indications in adults (18–59 years) were asymptomatic urinary abnormalities (75.3%) followed by nephrotic syndrome (19.8%) and acute kidney injury (AKI, 3.4%).

          Conclusions: Among 818 renal biopsy specimens, MsPGN and IgAN were the most frequent biopsy-proven renal diseases. MGN was the third most common cause of primary GN and lupus nephritis (LN) was the most common secondary glomerular disease. Our data contribute to the epidemiology of renal disease in South Korea.

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          The aging kidney revisited: a systematic review.

          Davide Bolignano, Francesco Mattace-Raso, Eric J. G. Sijbrands … (2014)
          As for the whole human body, the kidney undergoes age-related changes which translate in an inexorable and progressive decline in renal function. Renal aging is a multifactorial process where gender, race and genetic background and several key-mediators such as chronic inflammation, oxidative stress, the renin-angiotensin-aldosterone (RAAS) system, impairment in kidney repair capacities and background cardiovascular disease play a significant role. Features of the aging kidney include macroscopic and microscopic changes and important functional adaptations, none of which is pathognomonic of aging. The assessment of renal function in the framework of aging is problematic and the question whether renal aging should be considered as a physiological or pathological process remains a much debated issue. Although promising dietary and pharmacological approaches have been tested to retard aging processes or renal function decline in the elderly, proper lifestyle modifications, as those applicable to the general population, currently represent the most plausible approach to maintain kidney health.
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            Changing prevalence of glomerular diseases in Korean adults: a review of 20 years of experience.

            Jae Chang, Dong Ki Kim, Hyun Kim … (2009)
            The prevalence of glomerular diseases differs according to geographic area, race, age and indications for a renal biopsy. This study was conducted to evaluate the distribution and changing patterns of renal diseases during the past 20 years in a large patient population in Korea. Patients aged 16 years or older who underwent a renal biopsy at Severance Hospital in the Yonsei University Health System from 1987 to 2006 were enrolled. All medical records were reviewed retrospectively. In total, 1818 patients (M:F = 1.02:1) were reviewed. Glomerulonephritis (GN) comprised 85.9% of the total biopsied cases. The most common primary GN was IgA nephropathy (IgAN) (28.3%), which was followed by minimal change disease (MCD) (15.5%), membranous nephropathy (MN) (12.3%), focal segmental glomerulosclerosis (FSGS) (5.6%) and membranoproliferative GN (MPGN) (4.0%). The most common secondary GN was lupus nephritis (8.7%). The most common idiopathic nephrotic syndrome was MCD (38.5%), which was followed by MN and IgAN. Among 128 (7.4%) patients who were HBsAg-positive, MN (30.5%) and MPGN (21.1%) were the most common GN. When the incidence rates between 1987-91 and 2002-06 were compared, IgAN increased from 25.6 to 34.5%, while MCD (from 23.2 to 7.0%) and MPGN (from 6.7 to 1.7%) decreased significantly (P < 0.01). IgAN was the most common primary GN, and MCD was the most common cause of nephrotic syndrome. In the 5-year quartile comparison, the relative frequency of IgAN increased, while the relative frequency of MCD and MPGN decreased significantly during the past 20 years.
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              Clinicopathologic correlations of renal pathology in Spain.

              Francisco Rivera, Juan Manuel López-Gómez, Rafael Pérez-García (2004)
              There are not enough large epidemiologic population-based studies of biopsy-proven nephropathies with detailed clinicopathologic correlations. The Glomerulonephritis Registry of the Spanish Society of Nephrology has obtained data from 9378 cases with native biopsy-proven renal diseases and well-known clinical syndrome between 1994 and 2001, investigating clinicopathologic correlations. Patients were divided in three groups according to age: children ( 65 years). The most common clinical syndrome at any age is nephrotic syndrome (35.5%), followed by asymptomatic urinary abnormalities (25.9%), acute renal failure (12.9%), chronic renal failure (12.1%), nephritic syndrome (4.5%), macroscopic haematuria (4.5%), and arterial hypertension (3.0%). A male predominance is observed at any age (3:2). The frequencies of histologic findings are statistically different in all syndromes according to age. Minimal change disease is the most frequent finding in children with nephrotic syndrome (39.5%), whereas in adults and elderly, membranous nephropathy is the most prevalent (24.2% and 28.0%, respectively). Ig A nephropathy (IgAN) is the most frequent glomerulonephritis in patients with asymptomatic urinary abnormalities at any age. Acute renal failure is an important cause for performing a kidney biopsy in elderly and vasculitis is the main histologic finding. The clinical manifestations of focal segmental glomerulosclerosis, non-IgA mesangial nephropathy, lupus nephritis, vasculitis, and nephroangiosclerosis are statistically different according to age. The findings of clinicopathologic correlations obtained from the Spanish Registry of Glomerulonephritis on native biopsy-proven renal diseases add valuable information to previous reports and it can be the initial step for follow-up and prospective studies.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ren Fail
                Journal ID (iso-abbrev): Ren Fail
                Journal ID (publisher-id): IRNF
                Journal ID (publisher-id): irnf20
                Title: Renal Failure
                Publisher: Taylor & Francis
                ISSN (Print): 0886-022X
                ISSN (Electronic): 1525-6049
                Publication date Collection: 2017
                Publication date (Electronic): 19 July 2017
                Volume: 39
                Issue: 1
                Pages: 540-546
                Affiliations
                [a ]Department of Internal Medicine, Kosin University College of Medicine , Busan, Korea;
                [b ]Department of Pathology, Kosin University College of Medicine , Busan, Korea
                Author notes
                CONTACT Hark Rim rimhark@ 123456hanmail.net Department of Internal Medicine, Kosin University College of Medicine , 262 Gamcheon-ro, Seo-gu, Busan, 602-702, Korea
                Article
                Publisher ID: 1348955
                DOI: 10.1080/0886022X.2017.1348955
                PMC ID: 6014498
                PubMed ID: 28722531
                SO-VID: 8add54d4-cc8c-45a5-a18d-37b0807c24a5
                Copyright © © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 14 July 2016
                Date revision received : 26 January 2017
                Date accepted : 02 February 2017
                Page count
                Pages: 7, Words: 4853
                Categories
                Subject: Clinical Study

                ScienceOpen disciplines: Nephrology
                Keywords: renal disease,renal biopsy,igan,mspgn,mgn
                Data availability:
                ScienceOpen disciplines: Nephrology
                Keywords: renal disease, renal biopsy, igan, mspgn, mgn

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