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Reporting renal biopsies from Cyprus: a systematic approach
Düriye Deren Oygar1, Guy H Neild2
1Department of Nephrology, Nicosia State Hospital, Burhan Nalbantoglu General Hospital, North Cyprus.
Insights
Renal disease causes vary globally. In North Cyprus, primary glomerulonephritis (GN) is common, with secondary focal and segmental glomerulosclerosis (FSGS) frequently observed, potentially linked to monogenic disorders.
Area of Science:
- Nephrology
- Renal Pathology
- Epidemiology
Background:
- Renal disease etiology differs worldwide, with unknown or hypertension-related causes prevalent in the Middle East.
- This study focuses on the renal biopsy findings in North Cyprus.
Purpose of the Study:
- To establish a reproducible renal biopsy series for comparative analysis across different centers.
- To characterize the spectrum of kidney diseases in North Cyprus.
Main Methods:
- A 10-year retrospective analysis of native kidney biopsies from 153 adult patients in North Cyprus.
- Data collection included patient demographics and histopathological findings.
Main Results:
- The most common diagnoses were primary glomerulonephritis (GN) (56%) and secondary GN (27%).
- Secondary focal and segmental glomerulosclerosis (FSGS) was a significant finding (29% of primary GN cases).
- The incidence of IgA nephropathy was 6.3 per million population per year.
Conclusions:
- Standardized reporting of renal biopsy data, including population incidence (per million population/year) and biopsy rates, is crucial for inter-center comparison.
- Secondary FSGS is notably common in this population and may stem from monogenic causes.
- Further investigation into the genetic basis of FSGS in this region is warranted.
Background:
The etiology of renal disease varies in different parts of the world. In the Middle East, half of all patients reaching end-stage are categorised as either unknown etiology or hypertension-related nephropathy.
Objectives:
To report a renal biopsy series, in a reproducible format and manner, so that data can be compared directly among other series.
Patients And Methods:
Biopsies of native kidneys were performed in a 10-year period, at a tertiary referral hospital that provides the entire nephrology service for north Cyprus. Data are reported from 153 patients older than 17 years, who were either Turkish-Cypriot or from the Turkish mainland.
Results:
Mean biopsy rate was 48 per million population (pmp) per year. Mean age was 45.7 years (range 18-78). Overall, the sex distribution was similar (male 51%). The most common histopathological categories were primary glomerulonephritis (GN) (56%), secondary GN (27%), and tubulo-interstitial disease (14%). Of those with primary GN, 29% had secondary (2o) focal and segmental glomerulosclerosis (FSGS) (29%), followed by IgA nephropathy (24 %), membranous 18% and a further 11 patients with 1o FSGS (12%). The incidence of IgA nephropathy was 6.3 per pmp/year. When expressed as a percentage of the annual biopsy rate, 14% of all biopsies showed IgA nephropathy.
Conclusions:
To compare data among centres, they must be expressed in terms of the population (incidence pmp/year) and the biopsy rate. In our population, secondary FSGS is common and uncharacterised and we believe many will be caused by monogenic disease.
