Kidney biopsy diagnosis in childhood in the Norwegian Kidney Biopsy Registry and the long-term risk of kidney replacement therapy: a 25-year follow-up

Abstract

Background There is scarce information on biopsy-verifed kidney disease in childhood and its progression to chronic kidney disease stage 5 (CKD 5). This study aims to review biopsy fndings in children, and to investigate risk of kidney replacement therapy (KRT).<p> <p>Methods We conducted a retrospective long-term follow-up study of children included in the Norwegian Kidney Biopsy Registry (NKBR) and in the Norwegian Renal Registry (NRR) from 1988 to 2021. <p>Results In total, 575 children with a median (interquartile range, IQR) age of 10.7 (6.1 to 14.1) years were included, and median follow-up time (IQR) after kidney biopsy was 14.3 (range 8.9 to 21.6) years. The most common biopsy diagnoses were minimal change disease (MCD; n=92), IgA vasculitis nephritis (IgAVN; n=76), IgA nephropathy (n=63), and focal and segmental glomerulosclerosis (FSGS; n=47). In total, 118 (20.5%) of the biopsied children reached CKD 5, median (IQR) time to KRT 2.3 years (7 months to 8.4 years). Most frequently, nephronophthisis (NPHP; n=16), FSGS (n=30), IgA nephropathy (n=9), and membranoproliferative glomerulonephritis (MPGN; n=9) led to KRT. <p>Conclusions The risk of KRT after a kidney biopsy diagnosis is highly dependent on the diagnosis. None of the children with MCD commenced KRT, while 63.8% with FSGS and 100% with NPHP reached KRT. Combining data from kidney biopsy registries with registries on KRT allows for detailed information concerning the risk for later CKD 5 after biopsyverifed kidney disease in childhood.