SN Wong, KW Chan, MC Chiu, HK Paediatric Nephrology Study Group

Abstract

To study the role of renal biopsy in the evaluation of childhood glomerular diseases, we undertook a retrospective review of 150 renal biopsies performed for Chinese children below 16 years of age in nine major public hospitals in Hong Kong from January 1, 1991 to December 31, 1993. Among 75 children biopsied for nephrotic syndrome, pathological diagnosis included minimal change disease (MCD) (37), diffuse mesangial proliferation (DMP) (13), hepatitis B virus (HBV)-membranous nephropathy (7), focal segmental glomerulosclerosis (FSGS) (6). Diseases other than MCD-DMP-FSGS spectrum were diagnosed in 19 cases and all except 2 occurred in children presenting with nephritic-nephrotic features, positive serology for HBV, or steroid resistance. In 21 patients biopsied for persistent isolated hematuria, IgA nephropathy, Alport's syndrome, benign hematuria and proliferative endocapillary GN were diagnosed respectively in 10, 4, 6, and 1 patients. In 16 patients biopsied for persistent hematuria and proteinuria with or without other nephritic features, IgAN(5), proliferative endocapillary GN(5) and various other nephropathies(6) were found. Overall, the commonest primary glomerulonephritis were minimal change disease (MCD) (25%), IgA nephropathy (11%), and diffuse mesangial proliferation (DMP) (9%), while the commonest secondary glomerulonephritis were lupus nephritis (16%) and Schonlein-Henoch purpura (9%). The data showed local paediatric nephrologists performed renal biopsies only on selected patients and this was helpful in their diagnosis and treatment.