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Epidemiology and clinicopathological characteristics of native kidney disease in children in Flanders, Belgium

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Abstract

Background

The Flemish Collaborative Glomerulonephritis Group (FCGG) registry is a population-based kidney biopsy registry that has been including all native kidney biopsies performed in children in Flanders (Belgium), since 2017.

Methods

From 2017 to 2020, 148 pediatric (< 18 years) native kidney biopsies were included. Each biopsy received a histopathological and final nephrological diagnosis, and concordance between both was assessed. Disease chronicity, summarized by the Mayo Clinic Chronicity Score, was determined on 122 biopsies with > 5 glomeruli.

Results

Kidney biopsy rate was high (29.0 biopsies per million children per year), median age was 10.0 years (IQR 5.8–14.7), and boys predominated (56.1% males). A total of 140 biopsies (94.6%) showed a representative pathology result. Glomerular disease was most prevalent, with IgA nephropathy/IgA vasculitis (43 biopsies, 29.1%) and minimal change disease (MCD) (29 biopsies, 19.6%) being the overall most frequent diagnoses. In general, diagnostic concordance was high (80.7%). In Alport syndrome and focal segmental glomerulosclerosis (FSGS), concordance was lower, as the nephrological diagnosis was often determined by results of genetic analysis. Nephrotic syndrome was the most frequent indication for kidney biopsy (31.8%) and was mainly caused by MCD and FSGS. The degree of disease chronicity on kidney biopsies was generally low, although 27.3% of biopsies with a diagnosis of FSGS showed moderate-to-severe chronic damage.

Conclusions

The presented epidemiological findings validate data from previous European registry studies and may inspire kidney biopsy registries worldwide to implement novel features such as clinicopathological concordance and chronicity grading.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding authors on reasonable request.

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Acknowledgements

The authors wish to thank all collaborating nephrologists in Flanders and Brussels and responsible persons at the data entry centers (Elsie De Man, Sabine Verhofstede, Ben Sprangers) for their participation in the FCGG registry. The FCGG registry was initiated in collaboration with NBVN, a not-for-profit organization that represents nephrologists in Flanders.

Members of the FCGG collaborative group are mentioned in the Appendix. These members are collaborators, unless also mentioned in the author list above, in which case they are authors.

Funding

Dries Deleersnijder is supported by a PhD Fellowship grant fundamental research from the Research Foundation Flanders (F.W.O., grant number 11L5622N). Ben Sprangers is a senior clinical investigator of The Research Foundation Flanders (F.W.O., grant number 1842919 N). The FCGG registry is funded by the Nederlandstalige Belgische Vereniging voor Nefrologie (NBVN).

Author information

Authors and Affiliations

  1. Laboratory of Molecular Immunology, Department of Microbiology, Immunology and Transplantation, Rega Institute, KU Leuven, Louvain, Belgium

    Dries Deleersnijder, Louise Cools & Ben Sprangers

  2. Division of Nephrology, University Hospitals Leuven, Louvain, Belgium

    Dries Deleersnijder & Ben Sprangers

  3. Pediatric Nephrology and Solid Organ Transplantation, University Hospitals Leuven, Louvain, Belgium

    Noël Knops

  4. Department of Development and Regeneration, KU Leuven, Louvain, Belgium

    Noël Knops

  5. Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Wilrijk, Belgium

    Dominique Trouet & Amélie Dendooven

  6. Department of Pediatric Nephrology, Antwerp University Hospital, Edegem, Belgium

    Dominique Trouet & Koen Van Hoeck

  7. Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium

    Sevasti Karamaria, Johan Vande Walle & Wim Laurens

  8. Department of Pediatric Nephrology, Ghent University Hospital, Ghent, Belgium

    Sevasti Karamaria & Johan Vande Walle

  9. Department of Pediatrics, University Hospital Brussels, Brussels, Belgium

    Reiner Mauel

  10. Department of Nephrology, AZ Groeninge Hospital, Kortrijk, Belgium

    Gert Meeus

  11. Division of Pathology, University Hospital Ghent, Ghent, Belgium

    Amélie Dendooven

  12. Department of Nephrology and Dialysis, VITAZ Hospital, Sint-Niklaas, Belgium

    Johan De Meester & Wim Laurens

Authors
  1. Dries Deleersnijder
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Consortia

on behalf of the FCGG collaborative group

Contributions

DD, NK, DT, KVH, SK, JVW, RM, LC, GM, AD, JDM, WL, and BS were responsible for the conception, design, and data acquisition of the study. DD, NK, LC, AD, JDM, WL, and BS were responsible for analysis and interpretation of the data.

DD, NK, DT, KVH, SK, JVW, RM, LC, GM, AD, JDM, WL, and BS drafted the work and revised it critically for important intellectual content.

DD, NK, DT, KVH, SK, JVW, RM, LC, GM, AD, JDM, WL, and BS approved the submitted version of the manuscript.

DD, NK, DT, KVH, SK, JVW, RM, LC, GM, AD, JDM, WL, and BS agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding authors

Correspondence to Dries Deleersnijder or Ben Sprangers.

Ethics declarations

Ethics approval

This study was approved by the Ethical Committee of the University Hospitals Leuven (study reference S59182) and local committees of all participating centers. The study complied with all applicable regulatory requirements, Good Clinical Practice Guidelines, and the principles of the Declaration of Helsinki.

Consent to participate

Informed consent was obtained from all patients or their legal representative, as appropriate.

Competing interests

The authors declare no competing interests.

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The results presented in this paper have not been published previously in whole or part, except in abstract format.

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Supplementary file2 (DOCX 96 KB)

Appendix

Appendix

Appendix. “FCGG reference nephrologists” and collaborating (nephro-)pathologists of participating centers

Reference nephrologist

Center

An De Vriese

AZ Sint-Jan, Brugge

Anja De Rycke

AZ Sint-Blasius, Dendermonde

Anne-Marie Bogaert

AZ Glorieux, Ronse

Annemie Woestenburg

AZ Voorkempen, Malle

Bart Denys

Onze-Lieve-Vrouwziekenhuis, Aalst

Bart Maes

AZ Delta, Roeselaere

Domien Peeters

Sint-Trudo Ziekenhuis, Sint-Truiden

Hilde Vanbelleghem

Jan Yperman ziekenhuis, Ypres

Jan Donck

AZ Sint-Lucas, Ghent

Johan Scharpé, Nele De Clippeleir

GZA, Antwerp

Ann Colson

Kliniek Sint-Jan, Brussels

Karen Meyvis

AZ Monica, Antwerp

Kurt Vandepitte

Heilig-Hartziekenhuis, Lier

Liza-Maria Reyns

AZ Sint-Lucas, Brugge

Jacques Peeters

Ziekenhuis Oost-Limburg, Genk

Marc Decupere

AZ Groeninge, Kortrijk

Mark Helbert

ZNA, Antwerp

Miranda Zeegers

AZ Turnhout, Turnhout

Nathalie Neirynck

VITAZ, Sint-Niklaas

Pascale Bernaert

AZ Maria Middelares, Ghent

Tom Dejagere

Jessa Ziekenhuis, Hasselt

Wim Lemahieu

Imeldaziekenhuis, Bonheiden

Ben Sprangers

University Hospitals Leuven, Leuven

Lissa Pipeleers

University Hospital Brussels, Brussels

Rachel Hellemans

Antwerp University Hospital, Antwerp

Steven Van Laecke

Ghent University Hospital, Ghent

Noël Knops, Elena Levtchenko

Pediatric nephrology department, University Hospitals Leuven, Leuven

Sevasti Karamaria, Johan Vande Walle

Pediatric nephrology department, Ghent University Hospital, Ghent

Koen Van Hoeck, Dominique Trouet

Pediatric nephrology department, Antwerp University Hospital, Antwerp

Reiner Mauel

Pediatric nephrology department, University Hospital Brussels, Brussels

Pathologist

Center

Amélie Dendooven

Antwerp University Hospital, Antwerp and Ghent University Hospital, Ghent

Anne Hoorens, Jo Van Dorpe, Marleen Praet

Ghent University Hospital, Ghent

Caroline Geers

University Hospital Brussels, Brussels

Evelyne Lerut, Priyanka Koshy, Tania Roskams

University Hospitals Leuven, Leuven

Selda Aydin

Cliniques Universitaires Saint-Luc, Brussels

Vasiliki Siozopoulou

Antwerp University Hospital, Antwerp

Anne-Marie Schelfhout, Hendrik De Raeve

Onze-Lieve-Vrouwziekenhuis, Aalst

Edwin Steenkiste, Francesca Dedeurwaerdere

AZ Delta, Roeselaere

Ignace Dalle

AZ Sint-Lucas, Brugge

Kristof Cokelaere, Stijn Deloose

Jan Yperman ziekenhuis, Ypres

Pascale De Paepe

AZ Sint-Jan, Brugge

Peter Van Eyken

Ziekenhuis Oost-Limburg, Genk

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Deleersnijder, D., Knops, N., Trouet, D. et al. Epidemiology and clinicopathological characteristics of native kidney disease in children in Flanders, Belgium. Pediatr Nephrol 38, 1533–1545 (2023). https://doi.org/10.1007/s00467-022-05719-7

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