2003 Volume 49 Issue 2 Pages 215-221
Objective : The incidence of glomerular diseases was investigated according to our two indications for renal biopsy in Juntendo University Hospital. Patients and Methods : Renal biopsies were performed on 1,150 patients from1978 to 2000. The indication for renal biopsy differed with time as follows : (1) In the first period (1978-1986), renal biopsy was performed on patients with microscopic or macroscopic hematuria, proteinuria and/or nephrotic syndrome and (2) in the second period (1987-2000), renal biopsy was not performed on patients with only mild microscopic hematuria and patients with nephrotic syndrome without cellular casts and showing therapeutic effects of steroid therapy. The clinical course of those patients was divided into five types according to the WHO clinical classification. Results : The average number of patients undergoing renal biopsies per year in the first period was 75.4 patients and that in the second period was 33.6. Frequent diseases were IgA nephropathy (42%), non-IgA deposited proliferative glomerulonephritis and minor glomerular abnormalities (MGA) (13%), and membranous nephropathy (12%). In a comparison of the patients in the first and the second peroids, IgA nephropathy increased from 38% to 47%. Non-IgA deposited proliferative glomerulonephritis and MGA decreased from 17% to 7%. Membranous nephropathy increased from 10% to 17%. Chronic nephritic syndrome was associated with IgA nephropathy in 53% and nephrotic syndrome was associated with membranous nephropathy in 33% of patients. Conclusions : The most frequent renal disease was IgA nephropathy in spite of a change in the indication for renal biopsy. The decrease of renal biopsy patients in the second period and different frequencies of renal diseases between the first and second periods might be due to different indications for renal biopsy between the first and second periods. In spite of changes in the indication for renal biopsy, renal biopsy is necessary for diagnosis, selection of therapy and assessment of the prognosis of renal diseases.
