Original renal disease in a kidney-transplant population

Classification of the underlying renal disorder in kidney transplant patients involves some uncertainties. To allow evaluation of the risk of recurrence of renal disease in the transplanted kidney and other characteristics and risks inherent to the specific renal disorder we have investigated the basis for and reevaluated the diagnosis of 1000 consecutive patients who received transplants in Göteborg 1985-1993. In the original registry, 36% of patients had been given the diagnosis chronic glomerulonephritis but the diagnosis was confirmed by biopsy in only half of them, 18% of the total population. Systemic vasculitides and hereditary disorders other than adult polycystic kidney disease which constituted 3% and 6%, respectively, had frequently been overlooked. The term chronic pyelonephritis (15%) covered a variety of conditions including toxic tubulointerstitial disease, but was dominated by those caused by congenital urinary tract formations. Diabetic nephropathy (21%) was the consequence of Type 1 diabetes in 18% and Type 2 or other forms of diabetes in 3%. The proportion of patients with unknown cause of renal failure was 20%. The registry allows identification of small, distinct entities, which may be characterised as regards prerequisites for and consequences of kidney transplantation.