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J Nephropathol. 2017;6(3): 231-239.
doi: 10.15171/jnp.2017.38
PMID: 28975106
PMCID: PMC5607988
Scopus ID: 85019838250
  Abstract View: 3818
  PDF Download: 2873

Original Article

Reporting renal biopsies from Cyprus: a systematic approach

Düriye Deren Oygar 1, Guy H. Neild 2*

1 Department of Nephrology, Nicosia State Hospital, Burhan Nalbantoglu General Hospital, North Cyprus
2 UCL Centre for Nephrology, University College London, London NW3 2QG, UK
*Corresponding Author: *Corresponding author: Professor Guy H. Neild, , Email: g.neild@ucl.ac.uk

Abstract

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.


Implication for health policy/practice/research/medical education:

 
Evidence from the island of Cyprus suggests that renal failure is much more common than in western Europe. This is partly
owing to the high prevalence of familial renal disease and partly the burden of diabetes. The epidemiology of renal disease
throughout the Middle East is likely to be similar to Cyprus. To make progress in understanding renal disease, biopsy data
must be reported in a reproducible and systematic manner so that meaningful comparisons can be made amongst different
centres. Diabetic patients should be biopsied when the clinical renal findings are not consistent with diabetic nephropathy. It is
recommended that processing and reporting of renal biopsies is concentrated in centres able to perform immunoperoxidase
immunostaining on formalin-fixed tissue.

Please cite this paper as: Oygar DD, Neild GH. Reporting renal biopsies from Cyprus: a systematic approach. J Nephropathol.
2017;6(3):231-239. DOI: 10.15171/jnp.2017.38.

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Submitted: 04 Feb 2017
Accepted: 02 Apr 2017
ePublished: 13 Apr 2017
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