An analysis of 4,514 cases of renal biopsy in Korea

To evaluate the distribution and changing patterns of renal diseases in Kor ea, a total of 4,514 cases of renal biopsy collected over a 23-year period between 1973 and 1995 were reviewed. Of 4,200 cases excluding 314 unsatisfa ctory biopsies, adult cases comprised 59.5% and pediatric cases, 40.5%. The male to female ratio was 1.5:1 in adults and 2.2:1 in children. Glomerulon ephritis (GN) comprised 80.0% of the total. The most common primary GN in a dults was minimal change disease (MCD) (26.6%), followed by IgA nephropathy (IgAN) (22.1%), membranous GN (MGN) (11.8%), and membranoproliferative GN (MPGN) (5.9%). In children, the primary GN incidence rates were MCD (24.8%) , IgAN (10.3%), poststreptococcal (including postinfectious) GN (PSGN) (8.6 %), and focal segmental glomerulosclerosis (FSGS) (4.0%). The most common s econdary GN in adults was lupus nephritis and in children Henoch-Schonlein purpura nephritis. The most common cause of nephrotic syndrome was MCD in b oth adults and children, followed by MGN and FSGS. The elderly, aged sixty years and older, comprised 2.7% of cases and recorded equal numbers of MCD and MGN. The proportion of the biopsies found to be seropositive for HBs an tigen was 27.9%, and these showed either MGN or MPGN pattern. Repeat biopsy was performed in 168 patients, due to previous biopsy failure in 15.5%. Wh en the primary GN cases were analyzed at 5-year intervals, the prevalence o f PSGN, which was greater than 25% during the 1973-1982 period, decreased a bruptly in children thereafter, whereas the prevalence of FSGS increased sl owly since the 1988-1992 period in both adults and children. The decrease o f PSGN and the increase of FSGS suggest a role for socioeconomic and enviro nmental factors in Korea.