The Norwegian Kidney Register/National Center in … nbr 2008.pdf · 2018. 9. 29. · Annual report...

The Norwegian Kidney Register/National Center in Nephropathology Department of Medicine/Department of Pathology

Haukeland University Hospital

Head of the board: Bjarne M. Iversen, professor MD PhD Head of pathology: Leif Bostad, associate professor, MD

Annual report 2008

The Norwegian Kidney registry/National centre of Nephroropatology has continued the registration and research as in previous year. The reports from the hospitals have arrived fairly regularly, but still 88 clinical forms and 135 histopathological forms are lacking. From the start of the registry in1988, a total of 918 clinical forms are not in the registry. The figure on page 3 in the present report shows an overview of the missing reports from the different hospitals. It is still possible to include clinical and morphological data from patients taking biopsies from earlier years making the total registry more complete. At the end of 2008, a total of 9945 biopsies are now recorded in the registry. Our registry is the oldest active database in Europe and it is bigger than the Italian registry where they have no more money to continue their work. It is therefore necessary to keep our registry up and going and make it suitable for clinical control and renal research. The numbers of renal biopsies are still increasing and for the first time since we started Ullevål University Hospital and Rikshospitalet have the greatest numbers of biopsies and has passed Haukeland University Hospital. This observation indicates that the need for a renal biopsy in the daily diagnostic work is increasing. An increasing annual number of aged patients had a renal biopsy the last year. Renal biopsies in patients above 70 years are increasing, and we have now information from more than 1600 patients above 70 years of age. The biopsy procedure is safe in these patients, but the risk is slightly higher than in young patients. The overall frequency of complications is low (Page 38), in 2008, 3 patients needed blood transfusion and there was none that needed surgical intervention. The cases with macroscopical hematuria may be underreported. Hematoma is now deleted as a complication due to different practice in detection of this complication. Systematic use of ultrasound technique will detect a large number of hematoma, but this examination is not possible in all hospitals. Generally, the radiologists are more and more taking over the renal biopsy procedure. This seems to be in line with the continuous decline in renal procedures made by nephrologists. This development needs to be seriously discussed in the Norwegian Society of Nephrology. Research Knut Åsarød together with several others nephrologists and in collaboration with Leif Bostad are studying renal SLE in a large cohort in Norway. Rune Bjørneklett is working on IgA nephropathy and Bjørn Egil Vikse is continuing his work on renal disease and preeclampsia. Proteomics will be introduced on biopsies next year and Bjørn Egil Vikse has got funding for this procedure. Einar Svarstad, Camilla Tøndel and Leif Bostad are working on Fabrys disease. Camilla Tøndel will also make an in depth study of all complications after doing a renal biopsy.

The present report has been performed mainly by Else Reimers, the secretary of the Norwegian Kidney Registry. We are grateful for her skilled collaboration Guest: Gunnar Fjermeros from Sørlandet Sykehus Kristiansand was guest observer both in the Department of nephrology and Pathology from 1409-2409 2009. Leif Bostad Bjarne M. Iversen Associate professor, MD Professor MD, PhD

Alphabetical index Page

AAge and gender, total biopsies 13

C 17Clinical biopsy indication at different hospitalsClinical biosy 14Clinical indication for a renal biopsy (%) 15Clinical indication in different regions 16Clinical indications and morphology 26Complications to renal biopsy and who performed it 40Complications to renal biopsy performed by nephrologist 41Complications to renal biopsy performed by radiologist 42Complicatons to renal biopsies 38Complicatons to renal biopsies (%) 39

MMorphology 20Morphology at different hospitals 25Morphology in patients with chronical renal failure 30Morphology in patients with creatinine <200 33Morphology in patients with creatinine>200 32Morphology in patients with Hematuria 28Morphology in patients with Hematuria and proteinuria <3G/24H 29Morphology in patients with hypertension BP>140/90 31Morphology in patients with SLE 34Morphology in patients with the Nefrotic Syndrome and proteinuria >3g/24H 27Morphology, % of all 21

NNumber of clinical forms lacking at different hospitals 5Number of histopathological forms lacking at different hospitals 6Number of renal biopsies among different hospitals 11Number of renal biosies/100000 inhabitans 10Number of renal biopsies in 2005 2

RRenal biopsies in different regions 7Renal biopsies in different regions, related to gender 8Renal biopsy in different regions, by age 9Renal morphology, local pathologist 18Renal morphology, register pathologist 19Renal pathology in different regions 22- 23 - 24

SSLE based on clinical form information and on Diffus.prol. Lupusnephritis (IV) 35

TTotal number of clinical forms lacking at different hospitals 3Total number of histopathological forms lacking at different hospitals 4Total number of renal biopsies in males and females 12Total number of biopsies in The Norwegian Kidney Register 1

WWho performed the renal biopsy in Norway 36Who performed the renal biopsy at different hospitals 37

I Clinical Number

Total number of renal biopsies 626Biopsies lacking clinical form 88

Diagnosis Hematuria 211Hematuria with protenuria<3g/24h 13Nefrotic syndrom with proteinuria >3g/24h 24Chronical renal failure 181Hypertension BP >140/90 107SLE 24

Creatinine > 200 184Creatinine < 200 342

Complications Non complications 434Macroscopical hematuria 6Haematoma 47Blood transfusion 8Surgical intervention 0

II Morphology

Total number of renal biopsies 626Biopsies lacking histopathological form 135

Qality of biopsies Register pathologist: sufficient material 261Register pathologist: insufficient material 44Local pathologist: sufficient material 435Local pathologist: insufficient material 24

Diagnosis Minimal change 16Membranoproliferative GN 12Focal segmental sclerosis 32Benign nephrosclerosis 180Malign nephrosclerosis 3Membranous GN 36

Mesangioproliferative GN 110Mesangioproliferative GN with IgA 61Mesangioproliferativ GN without IgA 48Mesangioproliferative GN with SLE 1

Endocap proliferative GN 9Cresentic GN 31Diabetic nephropathy 25

Amyloidosis 15Diffus prol.Lupusnephritis(IV) 15

Congenital nephropathy 10Monoclonal Ig deposition disease 10Cryoglobulinemia with GN 0

Number in %

14,1

39,22,44,5

33,619,94,5

34,263,6

87,71,29,51,60,0

21,6

85,614,494,85,2

3,32,46,5

36,70,67,3

22,412,49,80,2

1,86,35,1

3,13,1

2,02,00,0

Total number of renal biopsies 9945Lacking clinical forms 913Lacking histopathological forms 2026

Total number of biopsies in The Norwegian Kidney Register

0

2000

4000

6000

8000

10000

12000

Total number of renal biopsies Lacking clinical forms Lacking histopathological forms

-1-

Total number of renal biopsies 626Lacking clinical forms 88Lacking histpopathological forms 135

Number of renal biopsies 2008

0

100

200

300

400

500

600

700

Total number of renal biopsies Lacking clinical forms Lacking histpopathological forms

-2-

Hospital NumberAkershus Universitetssykehus 110Fylkessjukehuset i Haugesund 38Førde Sentralsjukehus 2Haukeland Universitetssykehus 20Molde sjukehus 3Nordlandssykehuset 20Rikshospitalet 95Ringerike sjukehus 2St.Olavs Hospital 70Stavanger Universitetssykehus 12Stord sjukehus 24Sykehuset Buskerud 235Sykehuset Innlandet, Elverum 29Sykehuset Innlandet, Lillehammer 50Sykehuset Levanger 2Sykehuset Telemark 7Sykehuset Østfold, Fredrikstad 10Sykehuset Østfold, Sarpsborg 0Sørlandet Sykehus, Arendal 15Sørlandet Sykehus, Kristiansand 55Ullevål Universtetssykehus 38Universitetssykehuset Nord-Norge 45Vestfold Sentralsykehus 13Volda sjukehus 16Ålesund sjukehus 2

Total 913

Total number of clinical forms lacking at different hospitals

0

50

100

150

200

250

Akershus U

niversitetssykehus

Fylkessjukehuset i Haugesund

Førde Sentralsjukehus

Haukeland U

niversitetssykehus

Molde sjukehus

Nordlandssykehuset

Rikshospitalet

Ringerike sjukehus

St.O

lavs Hospital

Stavanger U

niversitetssykehus

Stord sjukehus

Sykehuset B

uskerud

Sykehuset Innlandet, E

lverum

Sykehuset Innlandet, Lilleham

mer

Sykehuset Levanger

Sykehuset Telem

ark

Sykehuset Ø

stfold, Fredrikstad

Sykehuset Ø

stfold, Sarpsborg

Sørlandet S

ykehus, Arendal

Sørlandet S

ykehus, Kristiansand

Ullevål U

niverstetssykehus

Universitetssykehuset N

ord-Norge

Vestfold S

entralsykehus

Volda sjukehus

Ålesund sjukehus

-3-

Hospital NumberAkershus Universitetssykehus 165Fylkessjukehuset i Haugesund 9Førde Sentralsjukehus 29Haukeland Universitetssykehus 176Molde sjukehus 9Nordlandssykehuset 49Rikshospitalet 230Ringerike sjukehus 15St.Olavs Hospital 119Stavanger Universitetssykehus 93Stord sjukehus 3Sykehuset Buskerud 143Sykehuset Innlandet, Elverum 21Sykehuset Innlandet, Lillehammer 142Sykehuset Levanger 46Sykehuset Telemark 20Sykehuset Østfold, Fredrikstad 60Sykehuset Østfold, Sarpsborg 1Sørlandet Sykehus, Arendal 53Sørlandet Sykehus, Kristiansand 20Ullevål Universtetssykehus 271Universitetssykehuset Nord-Norge 181Vestfold Sentralsykehus 113Volda sjukehus 4Ålesund sjukehus 54

Total number of histopathological forms lacking at different hospitals

0

50

100

150

200

250

300

Akershus U

niversitetssykehus



Haukeland U

niversitetssykehus

Molde sjukehus

Nordlandssykehuset

Rikshospitalet

Ringerike sjukehus

St.O

lavs Hospital

Stavanger U

niversitetssykehus

Stord sjukehus

Sykehuset B

uskerud

Sykehuset Innlandet, E

lverum

Sykehuset Innlandet, Lilleham

mer

Sykehuset Levanger

Sykehuset Telem

ark

Sykehuset Ø

stfold, Fredrikstad

Sykehuset Ø

stfold, Sarpsborg

Sørlandet S

ykehus, Arendal

Sørlandet S

ykehus, Kristiansand

Ullevål U

niverstetssykehus


ord-Norge

Vestfold S

entralsykehus

Volda sjukehus

Ålesund sjukehus

-4-

Total 88

Hospital NumberFørde Sentralsjukehus 2St.Olavs Hospital 28Stord sjukehus 1Sykehuset Buskerud 4Sykehuset Innlandet, Elverum 2Sykehuset Innlandet, Lillehammer 5Sykehuset Levanger 2Sykehuset Telemark 2Sørlandet Sykehus, Arendal 4Sørlandet Sykehus, Kristiansand 2Ullevål Universitetssukehus 3Universitetssykehuset Nord-Norge 33

Number of clinical forms lacking at different hospitals, 2008

0

5

10

15

20

25

30

35


St.O

lavs Hospital

Stord sjukehus

Sykehuset B

uskerud

Sykehuset Innlandet,

Elverum

Sykehuset Innlandet,

Lillehamm

er

Sykehuset Levanger

Sykehuset Telem

ark

Sørlandet S

ykehus, Arendal

Sørlandet S

ykehus,K

ristiansand

Ullevål U

niversitetssukehus


ord-N

orge

-5-

Total 135

Hospital NumberAkershus Universitetssykehus 7Fylkessjukehuset i Haugesund 0Førde Sentralsjukehus 3Haukeland Universitetssykehus 1Molde sjukehus 0Nordlandssykehuset 1Rikshospitalet 12Ringerike sykehus 1St.Olavs Hospital 9Stavanger Universitetssjukehus 4Stord sjukehus 0Sykehuset Buskerud 12Sykehuset Innlandet, Elverum 1Sykehuset Innlandet, Lillehammer 3Sykehuset Levanger 5Sykehuset Telemark 1Sykehuset Østfold, Fredrikstad 5Sørlandet Sykehus, Arendal 2Søsrlandet Sykehus, Kristiansand 1Ullevål Universtetssykehus 18Universitetssykehuset Nord-Norge 42Vestfold Sentralsykehus 4

Number of histopathological forms lacking at different hospitals, 2008

0

5

10

15

20

25

30

35

40

45

Akersh

us U

nivers

itetss

ykeh

us

Fylkes

sjuke

huse

t i Hau

gesu

nd

Førde Sen

tralsj

ukeh

us

Hauke

land U

nivers

itetss

ykeh

us

Molde s

jukeh

us

Nordlan

dssy

kehu

set

Riksho

spita

let

Ringeri

ke sy

kehu

s

St.Olav

s Hos

pital

Stavan

ger U

nivers

itetss

jukeh

us

Stord s

jukeh

us

Sykeh

uset

Buske

rud

Sykeh

uset

Innlan

det, E

lverum

Sykeh

uset

Innlan

det, L

illeha

mmer

Sykeh

uset

Leva

nger

Sykeh

uset

Telemark

Sykeh

uset

Østfold

, Fred

riksta

d

Sørland

et Syk

ehus

, Aren

dal

Søsrlan

det S

ykeh

us, K

ristia

nsan

d

Ullevå

l Univ

erstet

ssyk

ehus

Univers

itetss

ykeh

uset

Nord-N

orge

Vestfo

ld Sen

tralsy

kehu

s

Ålesun

d sjuk

ehus

-6-

Region NumberRegion Sør- Øst 356Region Vest 133Region Midt Norge 81Region Nord 56

Renal biopsies in different regions, 2008

0

50

100

150

200

250

300

350

400

Region Sør- Øst Region Vest Region Midt Norge Region Nord

-7-

Region Male Female TotalRegion Sør- Øst 213 143 356Region Vest 80 53 133Region Midt Norge 51 30 81Region Nord 39 17 56

Total 383 243 626

Renal biopsies in different regions, male and female, 2008

0

50

100

150

200

250

300

350

400


MaleFemaleTotal

-8-

Age Region Sør- Øst Region Vest Region Midt Norge Region Nord0 - 9 10 9 2 2

10 - 19 24 7 7 620 - 29 30 17 11 730 - 39 44 17 10 540 - 49 53 21 9 1050 - 59 67 21 13 860 - 69 73 19 16 570 - 79 35 20 8 980 - 89 20 2 5 4

90 - 0 0 0 0

Patient age and regions, 2008

0

10

20

30

40

50

60

70

80

0 - 9 10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 90 -


-9-

Region NumberRegion Sør- Øst 13,3Region Vest 13,3Region Midt Norge 12,1Region Nord 12,2

Number of renal biopsies /100000 inhabitans, 2008

11,4

11,6

11,8

12

12,2

12,4

12,6

12,8

13

13,2

13,4


-10-

Hospital NumberAkershus Universitetssykehus 21Fylkessjukehuset i Haugesund 6Førde Sentralsjukehus 13Haukeland Universitetssykehus 68Molde sjukehus 1Nordlandssykehuset 14Rikshospitalet 69Ringerike sykehus 11St.Olavs Hospital 48Stavanger Universitetssjukehus 41Stord sjukehus 5Sykehuset Buskerud 52Sykehuset Innlandet, Elverum 9Sykehuset Innlandet, Lillehammer 17Sykehuset Levanger 17Sykehuset Telemark 14Sykehuset Østfold, Fredrikstad 36Sykehuset Østfold, Sarpsborg 0Sørlandet Sykehus, Arendal 9Sørlandet Sykehus, Kristiansand 17Ullevål Universtetssykehus 82Universitetssykehuset Nord-Norge 42Vestfold Sentralsykehus 19Ålesund sjukehus 15Total 626

Number of renal biopsies at different hospitals, 2008

0

10

20

30

40

50

60

70

80

90

Ake

rshu

s U

nive

rsite

tssy

kehu

s

Fylk

essj

ukeh

uset

i H

auge

sund

Førd

e S

entra

lsju

kehu

s

Hau

kela

nd U

nive

rsite

tssy

kehu

s

Mol

de s

juke

hus

Nor

dlan

dssy

kehu

set

Rik

shos

pita

let

Rin

gerik

e sy

kehu

s

St.O

lavs

Hos

pita

l

Sta

vang

er U

nive

rsite

tssj

ukeh

us

Sto

rd s

juke

hus

Syk

ehus

et B

uske

rud

Syk

ehus

et In

nlan

det,

Elv

erum

Syk

ehus

et In

nlan

det,

Lille

ham

mer

Syk

ehus

et L

evan

ger

Syk

ehus

et T

elem

ark

Syk

ehus

et Ø

stfo

ld, F

redr

ikst

ad

Syk

ehus

et Ø

stfo

ld, S

arps

borg

Sør

land

et S

ykeh

us, A

rend

al

Sør

land

et S

ykeh

us, K

ristia

nsan

d

Ulle

vål U

nive

rste

tssy

kehu

s

Uni

vers

itets

syke

huse

t Nor

d-N

orge

Ves

tfold

Sen

trals

ykeh

us

Åle

sund

sju

kehu

s

-11-

n=626

Males 383 (61.2%)Females 243 (38.8%)

Total number of renal biopsies in males and females, 2008

0

50

100

150

200

250

300

350

400

450

Males Females

-12-

Age Male Female Total0 - 9 12 11 23

10 - 19 28 16 4420 - 29 34 31 6530 - 39 49 27 7640 - 49 50 43 9350 - 59 72 37 10960 - 69 79 34 11370 - 79 44 28 7280 - 89 15 16 3190 - 0 0 0

Age and gender, 2008

0

20

40

60

80

100

120

0 - 9 10 - 19 20 - 29 30 - 39 40 - 49 50 - 59 60 - 69 70 - 79 80 - 89 90 -

Male Female Total

-13-

Clinical indication NumberHematuria 211Hematuria with proteinuria <3g/24h 13Nefrotic syndrome with proteinuria >3g/24h 24Chronic renal failure 181Hypertension BP >140/90 107Creatinine > 200 184Creatinine< 200 342SLE 24

Cinical indications for a renal biopsy, 2008

0

50

100

150

200

250

300

350

400

Hematu

ria

Hematu

ria w

ith pr

oteinu

ria <3

g/24h

Nefroti

c syn

drome w

ith p

rotein

uria >

3g/24

h

Chronic

rena

l failu

re

Hypert

ensio

n BP >14

0/90

Creatin

ine > 20

0

Creatin

ine< 20

0SLE

-14-

n=538

Clinical indication %Hematuria 39,2Hematuria with proteinuria <3g/24h 2,4Nefrotic syndrome with proteinuria >3g/24h 4,5Chronic renal failure 33,6Hypertension BP >140/90 19,9Creatinine > 200 34,2Creatinine< 200 63,6SLE 4,5

Clinical indication for a renal biopsy (%), 2008

0

10

20

30

40

50

60

70

Hematu

ria

Hematu

ria w

ith pr

oteinu

ria <3

g/24h

Nefroti

c syn

drome w

ith pr

oteinu

ria >3g

/24h

Chronic

rena

l failu

re

Hypert

ensio

n BP >14

0/90

Creatin

ine > 20

0

Creatin

ine< 20

0SLE

-15-

Clinical indicationRegion Sør-Øst

Region Vest

Region Midt Norge

Region Nord

Hematuria 127 55 24 5Hematuria with proteinuria <3g/24h 3 3 5 2Nefrotic syndrome with proteinuria >3g/24h 11 2 6 5Chronic renal failure 119 47 10 5Hypertension BP >140/90 69 25 10 3Creatinine > 200 122 43 11 8Creatinine< 200 205 87 36 14SLE 14 6 2 2

Clinical indication in different regions, 2008

0

50

100

150

200

250

Hem

atur

ia

Hem

atur

ia w

ithpr

otei

nuria

<3g

/24h

Nef

rotic

syn

drom

e w

ithpr

otei

nuria

>3g

/24h

Chr

onic

rena

l fai

lure

Hyp

erte

nsio

n B

P>1

40/9

0

Cre

atin

ine

> 20

0

Cre

atin

ine<

200

SLE

Region Sør-Øst Region Vest Region Midt Norge Region Nord

-16-

Clinical indications at different hospitals, 2008

0 20 40 60 80 100 120 140 160 180

Akershus Universitetssykehus



Haukeland Universitetssykehus

Molde sjukehus

Nordlandssykehuset

Rikshospitalet

Ringerikesykehus

St.Olavs Hospital

Stavanger Universitetssjukehus

Stord sjukehus

Sykehuset Buskerud

Sykehuset Innlandet, Elverum

Sykehuset Innlandet, Lillehammer

Sykehuset Levanger

Sykehuset Telemark

Sykehuset Østfold, Fredrikstad

Sykehuset Østfold, Sarpsborg

Sørlandet sykehus, Arendal

Sørlandet sykehus, Kristiansand

Ullevål Universitetssykehus

Universitetssykehuset Nord-Norge

Vestfold Sentralsykehus

Volda sjukehus

Ålesund sjukehus

Hematuria Hematuria with proteinuria <3g/24h

Nefrotic syndrom with proteinuria >3g/24h Chronical renal failure

Hypertension BP>140/90 SLE

Creatinine >200 Creatinine < 200

-17-

Hospital Representative material Not representative materialAkershus Universitetssykehus 13 1Fylkessjukehuset i Haugesund 6 0Haukeland Universitetssykehus 61 4Molde sjukehus 1 0Nordlandssykehuset 12 1Rikshospitalet 51 2Ringerike sykehus 9 0St.Olavs Hospital 35 1Stavanger Universitetssjukehus 33 3Stord sjukehus 4 1Sykehuset Buskerud 36 2Sykehuset Innlandet, Elverum 7 0Sykehuset Innlandet, Lillehammer 13 0Sykehuset Levanger 10 1Sykehuset Telemark 12 0Sykehuset Østfold, Fredrikstad 29 2Sørlandet Sykehus, Arendal 6 1Sørlandet Sykehus, Kristiansand 15 3Ullevål Universitetssykehus 58 1Vestfold Sentralsykehus 14 1Ålesund sjukehus 10 0Total 435 24

Renal morphology, local pathologist, 2008

0

10

20

30

40

50

60

70

Akersh

us U

nivers

itetss

ykeh

us

Fylkes

sjuke

huse

t i Hau

gesu

nd

Hauke

land U

nivers

itetss

ykeh

us

Molde s

jukeh

us

Nordlan

dssy

kehu

set

Riksho

spita

let

Ringeri

ke sy

kehu

s

St.Olav

s Hos

pital

Stavan

ger U

nivers

itetss

jukeh

us

Stord s

jukeh

us

Sykeh

uset

Buske

rud

Sykeh

uset

Innlan

det, E

lverum

Sykeh

uset

Innlan

det, L

illeha

mmer

Sykeh

uset

Leva

nger

Sykeh

uset

Telemark

Sykeh

uset

Østfold

, Fred

riksta

d

Sørland

et Syk

ehus

, Aren

dal

Sørland

et Syk

ehus

, Kris

tians

and

Ullevå

l Univ

ersite

tssyk

ehus

Vestfo

ld Sen

tralsy

kehu

s

Ålesun

d sjuk

ehus

Representative material Not representative material

-18-

Hospital Representative materiale Not representative materialeAkershus Universitetssykehus 13 1Førde Sentralsjukehus 3 0Rikshospitalet 49 7Ringerike sykehus 9 1St.Olavs Hospital 34 3Sykehuset Buskerud 34 6Sykehuset Innlandet, Elverum 7 1Sykehuset Innlandet, Lillehammer 14 0Sykehuset Levanger 9 3Sørlandet Sykehus, Arendal 5 2Sørlandet Sykehus, Kristiansand 14 1Ullevål Universitetssykehus 47 15Vestfold Sentralsykehus 12 3Ålesund sjukehus 11 1

Total 261 44

Renal morphology, register patologist, 2008

0

10

20

30

40

50

60

Akersh

us U

nivers

itetss

ykeh

us

Førde Sen

tralsj

ukeh

us

Riksho

spita

let

Ringeri

ke sy

kehu

s

St.Olav

s Hos

pital

Sykeh

uset

Buske

rud

Sykeh

uset

Innlan

det, E

lverum

Sykeh

uset

Innlan

det, L

illeha

mmer

Sykeh

uset

Leva

nger

Sørland

et Syk

ehus

, Aren

dal

Sørland

et Syk

ehus

, Kris

tians

and

Ullevå

l Univ

ersite

tssyk

ehus

Vestfo

ld Sen

tralsy

kehu

s

Ålesun

d sjuk

ehus

Representative materiale Not representative materiale

-19-

Diagnosis NumberMinimal change 16Membranoproliferative GN 12Focal segmental sclerosis 32Benign nephrosclerosis 180Malign nephrosclerosis 3Membranous nephropathy 36Mesangioproliferative GN 110Mesangioproliferative GN with IgA 61Mesangioproliferative GN without IgA 48Mesangioproliferative GN with SLE 1Endocap proliferative GN 9Cresentic GN 31Diabeteic nephropathy 25Amyloidosis 15Diffus.prol Lupusnephritis (IV) 15Congenital nephropathy 10Monoclonal Ig deposition disease 10Cryoglobulinemia 0

Histopathology diagnosis, 2008

0

20

40

60

80

100

120

140

160

180

200

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Mesan

giopro

liferat

ive G

N with

IgA

Mesan

giopro

liferat

ive G

N with

out Ig

A

Mesan

giopro

liferat

ive G

N with

SLE

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diabete

ic ne

phrop

athy

Amyloido

sis

Diffus.p

rol Lu

pusn

ephri

tis (IV

)

Conge

nital

neph

ropath

y

Monoc

lonal

Ig de

posit

ion di

seas

e

Cryoglo

bulin

emia

-20-

n=491Diagnosis %Minimal change 3,3Membranoproliferative GN 2,4Focal segmental sclerosis 6,5Benign nephrosclerosis 36,7Malign nephrosclerosis 0,6Membranous nephropathy 7,3Mesangioproliferative GN 22,4Mesangioproliferative GN with IgA 12,4Mesangioproliferative GN without IgA 9,8Mesangioproliferative GN with SLE 0,2Endocap proliferative GN 1,8Cresentic GN 6,3Diababetic nephropathy 5,1Amyloidosis 3,1Diffus.prol Lupusnephritis(IV) 3,1Congenital nephropathy 2,0Monoclonal Ig deposition disease 2,0Cryoglobulinemia 0,0

Histopathology diagnosis % of all, 2008

0,0

5,0

10,0

15,0

20,0

25,0

30,0

35,0

40,0

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Mesan

giopro

liferat

ive G

N with

IgA

Mesan

giopro

liferat

ive G

N with

out Ig

A

Mesan

giopro

liferat

ive G

N with

SLE

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diabab

etic n

ephro

pathy

Amyloido

sis

Diffus.p

rol Lu

pusn

ephri

tis(IV

)

Conge

nital

neph

ropath

y

Monoc

lonal

Ig de

posit

ion di

seas

e

Cryoglo

bulin

emia

-21-

DiagnosisRegion

Sør- ØstRegion

VestRegion Midt

NorgeRegion Nord

Focal segmental sclerosis 21 7 4 0Benign nephrosclerosis 114 46 17 3Malign nephrosclerosis 2 1 0 0Mesangioproliferative GN 65 27 15 3Mesangioproliferative GN with IgA 34 18 7 2Mesangioproliferative GN without IgA 31 8 8 1Mesangioproliferativ GN with SLE 0 0 0 1Membranous nephropathy 17 6 11 2

Renal pathology in different regions, 2008

0

20

40

60

80

100

120

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Mesan

giopro

liferat

ive G

N

Mesan

giopro

liferat

ive G

N with

IgA

Mesan

giopro

liferat

ive G

N with

out Ig

A

Mesan

giopro

liferat

iv GN w

ith S

LE

Membra

nous

neph

ropath

y

Region Sør- ØstRegion VestRegion Midt NorgeRegion Nord

-22-

DiagnosisRegion

Sør- ØstRegion

VestRegion Midt

NorgeRegion Nord

Minimal change 10 3 1 2Membranoproliferative GN 5 5 1 1Endocap proliferative GN 3 6 0 0Cresentic GN 17 11 2 1Diabetic nephropathy 16 8 1 0Amyloidosis 8 4 2 1SLE 8 5 1 1


0

2

4

6

8

10

12

14

16

18

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diabeti

c nep

hropa

thy

Amyloido

sis SLE

Region Sør- ØstRegion VestRegion Midt NorgeRegion Nord

-23-

DiagnosisRegion Sør-Øst

Region Vest

Region Midt Norge

Region Nord

Congenital nephropathy 4 5 0 1Monoclonal IG deposition disease 7 3 0 0Cryoglobulinemia with GN 0 0 0 0


0

1

2

3

4

5

6

7

8

Region

Sør-Ø

st

Region

Ves

t

Region

Midt

Norg

e

Region

Nord

Congenital nephropathy

Monoclonal IG depositiondisease

Cryoglobulinemia with GN

-24-

Clinical indication with morphology, 2008

0 50 100 150 200 250 300

Hematura

Hematuria withproteinuria<3g/24h

Nephroticsyndrome with

proteinuria >3g/24h

Chronical renalfailure

HypertensionBP>140/90

SLE

Creatinine> 200

Creatinine< 200

Minimal change

Focal segmental sclerosis

Diffus prol. Lupusnephritis

Endokap prol GN

Membranous nephropathy

Membranoproliferative GN

Cresentic GN

Benign nephrosclerosis

Malign nephrosclerosis

Diabetic nephropathy

Mesangioproliferative GN

Amyloidosis

-26-

Morphology NumberMinimal change 4Membranoproliferative GN 3Focal segmental sclerosis 2Benign nephrosclerosis 7Malign nephrosclerosis 1Membranous nephropathy 5Mesangioproliferative GN 2Endocap proliferative GN 0Cresentic GN 1Diffus prol.Lupusnephritis(IV) 1Diabetic nephropathy 0Amyloidosis 2

Morphology in patients with nefrotic syndrom and proteinuria>3g/24h, 2008

0

1

2

3

4

5

6

7

8

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

ephri

tis(IV

)

Diabeti

c nep

hropa

thy

Amyloido

sis

-27-

Morphology NumberMinimal change 2Membranoproliferative GN 7Focal segmental sclerosis 6Benign nephrosclerosis 52Malign nephrosclerosis 0Membranous nephropathy 6Mesangioproliferative GN 63Endocap prolifetative GN 6Cresentic GN 18Diffus prol.Lupusnephritis(IV) 5Diabetic nephropathy 8Amyloidosis 0

Morphology in patiens with Hematuria,2008

0

10

20

30

40

50

60

70

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifet

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

ephri

tis(IV

)

Diabeti

c nep

hropa

thy

Amyloido

sis

-28-


Morphology in patients with hematuria and proteinuria <3g/24h, 2008

0

1

2

3

4

5

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

ephri

tis(IV

)

Diabeti

c nep

hropa

thy

Amyloido

sis

-29-

Morphology NumberMinimal change 0Membranoproliferative GN 0Focal segmental sclerosis 9Benign nephrosclerosis 79Malign nephrosclerosis 1Membranous nephropathy 4Mesangioproliferative GN 22Endocap proliferative GN 1Cresentic GN 1Diffus prol.Lupusnefritis(IV) 1Diabetic nephropathy 17Amyloidosis 7

Morpholigy in patients with chronical renal failure, 2008

0

10

20

30

40

50

60

70

80

90

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

efritis

(IV)

Diabeti

c nep

hropa

thy

Amyloido

sis

-30-

Morphology NumberMinimal change 1Membranoproliferativ GN 3Focal segmental sclerosis 8Benign nephrosclerosis 52Malign nephrosclerosis 3Membranous nephropathy 3Mesangioproliferative GN 13Endocap proliferative GN 3Cresentic GN 6Diffus prol.Lupusnephritis(IV) 2Diabetic nephropathy 9Amyloidosis 4

Morphology in patients with hypertension BP >140/90, 2008

0

10

20

30

40

50

60

Minimal

chan

ge

Membra

nopro

liferat

iv G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

ephri

tis(IV

)

Diabeti

c nep

hropa

thy

Amyloido

sis

-31-


Morphology in patients with creatinine >200, 2008

0

10

20

30

40

50

60

70

80

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

ephri

tis(IV

)

Diabeti

c nep

hropa

thy

Amyloido

sis

-32-


Morphology in patients with creatinine <200, 2008

0

10

20

30

40

50

60

70

80

90

100

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

ephri

tis(IV

)

Diabeti

c nep

hropa

thy

Amyloido

sis

-33-


Morphology in patients with SLE, 2008

0

1

2

3

4

5

6

7

8

9

Minimal

chan

ge

Membra

nopro

liferat

ive G

N

Focal

segm

ental

scler

osis

Benign

neph

roscle

rosis

Malign

neph

roscle

rosis

Membra

nous

neph

ropath

y

Mesan

giopro

liferat

ive G

N

Endoc

ap pr

olifer

ative

GN

Cresen

tic G

N

Diffus p

rol.Lu

pusn

ephri

tis(IV

)

Diabeti

c nep

hropa

thy

Amyloido

sis

-34-

Clinical indication NumberHematuria 6Hematuria with proteinuria <3g/24h 0Nephrotic syndrome with proteinuria >3g/24h 1Chronic renal failurer 6Hypertension BP>140/90 2Creatinine> 200 3Creatinine < 200 14Diffus prol.Lupusnephritis 6

SLE based on clinical form information and on Diffus prol. Lupus nephritis, 2008

0

2

4

6

8

10

12

14

16

Hematu

ria

Hematu

ria w

ith p

rotein

uria <

3g/24

h

Nephro

tic sy

ndrom

e with

prote

inuria

>3g/2

4h

Chronic

rena

l failu

rer

Hypert

ensio

n BP>1

40/90

Creatin

ine> 2

00

Creatin

ine <

200

Diffus p

rol.Lu

pusn

ephri

tis

-35-

Performed the biopsy NumberNephrologist 95Radiologist 226Both 136Others 1

Those who performed the renal biopsy in Norway 2008

0

50

100

150

200

250

Nephrologist Radiologist Both Others

-36-

Hospital Nephrologist Radiologist Both OthersAkershus Universitetssykehus 0 20 0 0Fylkessjukehuset i Haugesund 0 6 0 0Førde Sentralsjukehus 0 0 13 0Haukeland Universitetssykehus 53 10 0 0Molde sjukehus 0 1 0 0Nordlandssykehuset 0 0 11 0Rikshospitalet 2 22 47 0Ringerike sykehus 0 8 1 0St.Olavs Hospital 0 11 0 0Stavanger Universitetssjukehus 34 0 1 0Stord sjukehus 0 4 0 0Sykehuset Buskerud 0 18 17 0Sykehuset Innlandet, Elverum 0 5 0 0Sykehuset Innlandet, Lillehammer 0 10 1 0Sykehuset Levanger 0 5 10 0Sykehuset Telemark 0 0 12 0Sykehuset Østfold, Fredrikstad 0 11 21 1Sørlandet Sykehus, Arendal 0 4 0 0Sørlandet Sykehus, Kristiansand 0 13 0 0Ullevål Universtetssykehus 5 51 0 0Universitetssykehuset Nord-Norge 0 6 2 0Vestfold Sentralsykehus 1 7 0 0Ålesund sjukehus 0 14 0 0

Toltal 95 226 136 1

Those who performed the renal biopsy at different hospitals, 2008

0

10

20

30

40

50

60

Aker

shus

Uni

vers

itets

syke

hus

Fylk

essj

ukeh

uset

i H

auge

sund

Førd

e Se

ntra

lsju

kehu

s

Hau

kela

nd U

nive

rsite

tssy

kehu

s

Mol

de s

juke

hus

Nor

dlan

dssy

kehu

set

Rik

shos

pita

let

Rin

gerik

e sy

kehu

s

St.O

lavs

Hos

pita

l

Stav

ange

r Uni

vers

itets

sjuk

ehus

Stor

d sj

ukeh

us

Syke

huse

t Bus

keru

d

Syke

huse

t Inn

land

et, E

lver

um

Syke

huse

t Inn

land

et, L

illeha

mm

er

Syke

huse

t Lev

ange

r

Syke

huse

t Tel

emar

k

Syke

huse

t Øst

fold

, Fre

drik

stad

Sørla

ndet

Syk

ehus

, Are

ndal

Sørla

ndet

Syk

ehus

, Kris

tians

and

Ulle

vål U

nive

rste

tssy

kehu

s

Uni

vers

itets

syke

huse

t Nor

d-N

orge

Vest

fold

Sen

trals

ykeh

us

Åles

und

sjuk

ehus


-37-

Macroscopical hematuria 6Haematoma 47Need for blood tranfusion 8Surgical intervention 0

Complications to renal biopsies, 2008

0

5

10

15

20

25

30

35

40

45

50

Macroscopical hematuria Haematoma Need for blood tranfusion Surgical intervention

-38-

Macroscopical hematuria 1,2Haematoma 9,5Need for blood tranfusion 1,6Surgical intervention 0

Complication to renal biopsies (%), 2008

0

1

2

3

4

5

6

7

8

9

10

Macroscopical hematuria Haematoma Need for blood tranfusion Surgical intervention

-39-

Complications Nephrologist Radiologist Both OthersMacroscopical hematuria 0 4 2 0Haematoma 2 32 11 0Blood transfusion 0 4 4 0Surgical intervention 0 0 0 0

Complications to renal biopsies and who performed it, 2008

0

5

10

15

20

25

30

35


Macroscopicalhematuria

Haematoma

Blood transfusion

Surgical intervention

-40-

Hospital Macroscopical

hematuria HaematomaBlood

transfusionSurgical

interventionAkershus Universitetssykehus 1 0 1 0Fylkessjukehuset i Haugesund 1 0 0 0Haukeland Universitetssykehus 0 4 0 0Rikshospitalet 0 7 0 0Ringerike sykehus 0 2 0 0St.Olavs Hospital 0 1 0 0Stord sjukehus 0 1 0 0Sykehuset Buskerud 0 3 0 0Sykehuset Innlandet, Lillehammer 0 1 0 0Sykehuset Østfold, Fredrikstad 0 2 0 0Sørlandet Sykehus, Kristiansand 0 2 0 0Ullevål Universtetssykehus 1 4 0 0Universitetssykehuset Nord-Norge 0 1 1Ålesund sjukehus 1 4 2 0

Total 4 32 4 0

Complications to renal biopsy performed by radiologist, 2008

0

1

2

3

4

5

6

7

8

Akersh

us U

nivers

itetss

ykeh

us

Fylkes

sjuke

huse

t i Hau

gesu

nd

Hauke

land U

nivers

itetss

ykeh

us

Riksho

spita

let

Ringeri

ke sy

kehu

s

St.Olav

s Hos

pital

Stord s

jukeh

us

Sykeh

uset

Buske

rud

Sykeh

uset

Innlan

det, L

illeha

mmer

Sykeh

uset

Østfold

, Fred

riksta

d

Sørland

et Syk

ehus

, Kris

tians

and

Ullevå

l Univ

erstet

ssyk

ehus

Univers

itetss

ykeh

uset

Nord-N

orge

Ålesun

d sjuk

ehus

Macroscopical hematuriaHaematomaBlood transfusionSurgical intervention

-42-

The Norwegian Kidney Register/National Center in … nbr 2008.pdf · 2018. 9. 29. · Annual report...

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