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CHAPTER 4 Paediatric Renal Biopsies

This report examines the analysis and findings of paediatric renal biopsies in Malaysia, including the number of patients, biopsies, histopathology diagnoses, and clinical characteristics. It also explores the survival rates of patients with specific renal diseases.

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CHAPTER 4 Paediatric Renal Biopsies

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  1. CHAPTER 4Paediatric Renal Biopsies Lee Ming LeeLim Yam NgoLynster LiawMirunalini a/p Appadurai Selva Kumar a/l Sivapuniam Susan PeeWan Jazilah Wan IsmailYap Yok Chin

  2. Table 4.2.2: Number of patients from various hospitals 4th MRRB report 2010, Malaysia

  3. Table 4.2.3: Number of renal biopsies 4th MRRB report 2010, Malaysia

  4. Table 4.2.4: Number of biopsies done on each patients at different times 4th MRRB report 2010, Malaysia

  5. Table 4.3.1: Conclusive report 4th MRRB report 2010, Malaysia

  6. Table 4.3.2: Number of glomeruli obtained at each biopsy *7 cases with missing number of glomeruli 4th MRRB report 2010, Malaysia

  7. Table 4.4.1: Gender and racial distribution 4th MRRB report 2010, Malaysia

  8. Table 4.4.2: Age distribution 4th MRRB report 2010, Malaysia

  9. Table 4.5.1: Clinical presentation at biopsy 4th MRRB report 2010, Malaysia

  10. Table 4.5.2: Renal function at biopsy 4th MRRB report 2010, Malaysia

  11. Table 4.5.3: Hypertension at biopsy 4th MRRB report 2010, Malaysia

  12. Table 4.6.1: Diagnosis of paediatric renal biopsies *Patients may have more than 1 diagnosis classification 4th MRRB report 2010, Malaysia

  13. Table 4.6.2 Annual frequency of the main renal biopsy findings 1999-2010 HSP: Henoch Schonlein Purpura *Patients may have more than 1 diagnosis classification 4th MRRB report 2010, Malaysia

  14. Table 4.7.1: Renal histopathology diagnosis of children presenting with nephrotic syndrome *Patients may have more than 1 diagnosis classification ** Others – Henoch Schonlein Purpura, HUS/TTP, Systemic vasculitis, Malignancy, Membranous nephropathy, Membrano-proliferative, Idiopathic crescentic GN, Acute interstitial nephritis, Acute tubular necrosis, Chronic interstitial nephritis, Hereditary (others), Advance GN, Others 4th MRRB report 2010, Malaysia

  15. Table 4.7.2: The histopathological profile in different steroid response categories *Patients may have more than 1 diagnosis classification ** Others – Henoch Schonlein Purpura, Membranous nephropathy, Membrano-proliferative, Idiopathic crescentic GN, Acute interstitial nephritis, Acute tubular necrosis, Chronic interstitial nephritis, Advance GN, Others 4th MRRB report 2010, Malaysia

  16. Table 4.8: Renal histopathology diagnosis of children presenting with nephritic syndrome *Patients may have more than 1 diagnosis classification ** Others – HUS/TTP, Anti GBM disease, Advance GN, Systemic vasculitis, Membrano-proliferative, Idiopathic crescentic GN, Acute interstitial nephritis, Chronic interstitial nephritis, Alport’s syndrome 4th MRRB report 2010, Malaysia

  17. Table 4.9: Histology finding of children who had severe renal failure (needed dialysis therapy) who underwent renal biopsy * Membrano-proliferative, Messangial Proliferative GN-non lgA, Idiopathic Crescentic GN, Henoch scholein purpura, Systemic vasculitis, Malignancy, Chronic interstitial nephritis, Others 4th MRRB report 2010, Malaysia

  18. Table 4.10.1: Clinical characteristics of children with steroid resistant nephrotic syndrome a, c, j, k, l Performed Wilcoxon Rank Sum test b, d, f, h Performed Chi-square test e, g, i, m Performed Fisher’s exact test 4th MRRB report 2010, Malaysia

  19. Continue; a, c, j, k, l Performed Wilcoxon Rank Sum test b, d, f, h Performed Chi-square test e, g, i, m Performed Fisher’s exact test 4th MRRB report 2010, Malaysia

  20. Table 4.10.2: Patient survival for focal segmental glomerulosclerosis and minimal change disease 4th MRRB report 2010, Malaysia

  21. Figure 4.10.2: Patient survival by focal segmental glomerulosclerosis and minimal change disease 4th MRRB report 2010, Malaysia

  22. Table 4.10.3: Renal survival of patient with focal segmental glomerulosclerosis and minimal change disease 4th MRRB report 2010, Malaysia

  23. Figure 4.10.3: Renal survival by focal segmental glomerulosclerosis and minimal change … 1.00 0.75 Cumulative Survival 0.50 0.25 0.00 0 50 100 150 Duration (months) FSGS MCD 4th MRRB report 2010, Malaysia

  24. Table 4.11.1: Total number of patient and biopsies (SLE) 4th MRRB report 2010, Malaysia

  25. Table 4.11.2: Distribution of renal biopsy in patients with lupus by numbers of biopsy 4th MRRB report 2010, Malaysia

  26. Table 4.11.3.1: Gender distribution for paediatric lupus nephritis 4th MRRB report 2010, Malaysia

  27. Table 4.11.3.2: Racial distribution for paediatric lupus nephritis 4th MRRB report 2010, Malaysia

  28. Table 4.11.3.3 Age for paediatric lupus nephritis 4th MRRB report 2010, Malaysia

  29. Table 4.11.3.4 Dialysis therapy for paediatric lupus nephritis at the time of biopsy 4th MRRB report 2010, Malaysia

  30. Table 4.11.3.5: Patient with hypertension (SLE) 4th MRRB report 2010, Malaysia

  31. Table 4.11.3.6: Clinical presentation at biopsy (SLE) 4th MRRB report 2010, Malaysia

  32. Table 4.11.4(a): Clinical presentation of paediatric lupus 4th MRRB report 2010, Malaysia

  33. Table 4.11.4(b): ARA criteria at presentation 4th MRRB report 2010, Malaysia

  34. Table 4.11.5: Classification of paediatric lupus nephritis 4th MRRB report 2010, Malaysia

  35. Table 4.11.6: Patients survival in lupus nephritis 4th MRRB report 2010, Malaysia

  36. Figure 4.11.6: Patient survival in lupus nephritis 1.00 0.75 Cumulative Survival 0.50 0.25 0.00 0 50 100 150 Duration (months) 4th MRRB report 2010, Malaysia

  37. Table 4.11.7: Renal survival of patients with lupus nephritis (ESRF&ESRF+died) 4th MRRB report 2010, Malaysia

  38. Figure 4.11.7: Renal survival of patient with lupus nephritis ... 1.00 0.75 Cumulative Survival 0.50 0.25 0.00 0 50 100 150 Duration (months) 4th MRRB report 2010, Malaysia

  39. Table 4.12: Causes of end stage renal disease in children who underwent renal biopsy 4th MRRB report 2010, Malaysia

  40. Table 4.13.1: Frequency of complication 4th MRRB report 2010, Malaysia

  41. Table 4.13.2: Risk factors for complication (ref*) Reference category CI-confidence interval ** Not able to do compute due to the small sample size a No information on renal failure needed dialysis for biopsy procedure data b No information on calculated gfr for biopsy procedure data c No information on haemoglobin (Hgb) level for biopsy procedure data d No information ultrasound biopsy for biopsy procedure data e No information on plug biopsy for biopsy procedure data f No information on needle size for biopsy procedure data g No information on number of passes for biopsy procedure data 4th MRRB report 2010, Malaysia

  42. Continue; (ref*) Reference category CI-confidence interval ** Not able to do compute due to the small sample size a No information on renal failure needed dialysis for biopsy procedure data b No information on calculated gfr for biopsy procedure data c No information on haemoglobin (Hgb) level for biopsy procedure data d No information ultrasound biopsy for biopsy procedure data e No information on plug biopsy for biopsy procedure data f No information on needle size for biopsy procedure data g No information on number of passes for biopsy procedure data 4th MRRB report 2010, Malaysia

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