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무증상 소변이상 환아의 조직병리학적 고찰: 단일병원의 20년간의 경험
임령경 ( Roung Koung Lim ),전종근 ( Chong Kun Cheon ),김수영 ( Su Young Kim ) 대한신장학회 2011 Kidney Research and Clinical Practice Vol.30 No.5
Purpose: There has been several studies about pathological findings of the asymptomatic urinary abnormalities (AUA) in children. But most of them are based on collaboratively collected data. That kinds of studies might have some bias due to different criteria for renal biopsy. We analyzed histopathological findings of AUA patients experienced in a single hospital and analyzed the efficacy of renal biopsy according to the clinical findings. Methods: We reviewed the pathological reports and clinical data of 171 patients with AUA who had renal biopsies for the last 20 years. Patient were divided into 3 groups based on the urinalysis: hematuria group, proteinuria group, combined hematuria and proteinuria group. To analyze the efficacy of renal biopsy, we defined "modifiable diseases" as those diseases of which early treatment can alter the prognosis, including IgA nephropathy, membranoproliferative glomerulonephritis, membranous glomerulonephritis and focal segmental glomerulosclerosis. Results: Male to female ratio was 2.2 to and the highest incidence was in the age group of 6 to 10 years. IgA nephropathy (49%) was the most frequent pathological diagnosis. The incidence of "modifiable diseases" were higher in the group of combined proteinuria and hematuria, compared to isolated hematuria or proteinuria group. Conclusion: IgA nephropathy was most frequent pathological diagnostic entity in AUA. The efficacy of renal biopsy, which can be defined as the possibility of diagnosing "modifiable disease" by renal biopsy, is greater in the combined hematuria and proteinuria group than hematuria or proteinuria group.
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