Introdução: A biopsia renal e fundamental na abordagem diagnostica e no prognostico de doentes com patologias nefrológicas. No sentido de avaliar a epidemiologia das doenças renais na Região Autónoma da Madeira e a sua evolução, analisou-se as biopsias de rim nativo nos ultimos vinte e sete anos. Métodos: Procedeu-se a análise retrospectiva dos registos e laminas histológicas de 1986-2012, com avaliação da evolução temporal na qualidade/indicações para biopsia renal e padrões de patologias nefrologicas. Resultados: A amostra compreende 315 biopsias de rim nativo, sendo a idade media dos doentes de 40.8 ± 18.4 anos, sendo 50.5% (n = 159) do sexo masculino. As síndromes nefrologicas mais frequentes foram a sindrome nefrotica (36.2%, n = 114) e lesão renal aguda (20.0%, n = 63). Das patologias nefrologicas mais frequentes, destacam-se no grupo das glomerulopatias primárias (41.5%, n = 115), a nefropatia de IgA (26.1%, n = 30) e a glomeruloesclerose segmentar e focal (17.4%, n = 20) e nas glomerulopatias secundarias (31.4%, n = 87), a nefrite lupica (51.7%, n = 45) e amiloidose (20.7%, n = 18). Na analise estatistica, realca-se a correlação significativa entre sexo e grupos de sindromes nefrologicas (Fisher’s exact test, p<.01) e entre grupos de sindromes nefrologicas e diagnostico patologicos (χ2, p <.01). Avaliando a evolução temporal, não se objectivaram diferencas estatisticamente significativas em relação ao numero de biopsias renais (χ2, p =.193), numero de glomerulos na amostra (Fisher’s exact test, p =.669), idade (Kruskal-Wallis, p =.216), sindromes nefrologicas (χ2, p =.106) ou grandes grupos de diagnostico patologicos (χ2, p =.649). No entanto, considerando os dignósticos patologicos especificos e a sua variação temporal foram encontradas diferencas significativas (Fisher’s exact test, p <.05) para nefrite lupica e nefropatia membranosa com uma incidencia crescente e para a amiloidose com uma tendência oposta. Discussão: A analise do registo de biopsias renais de uma população com características particulares, isolada geograficamente, permitiu mostrar concordância com outros números epidemiológicos referentes a outras subpopulações europeias, permitindo simultaneamente uma compreensão das directrizes locais sobre biopsias renais.
Introduction: Renal biopsy plays an essential role either in the diagnosis or in the prognosis of patients with renal disease. In order to assess its epidemiology and evolution in Madeira Islands, we analysed twenty-seven years of native kidney biopsies. Methods: We performed a retrospective analysis of clinical records, including histological revision from 1986 to 2012, totalling 315 native kidney biopsies. They were assessed regarding the temporal evolution both for the quality/indications for renal biopsy and for the patterns of kidney disease. Results: A total of 315 native kidney biopsies were analysed. The patients’ mean age was of 40.8 �± 18.4 years and 50.5%(n = 159) were males. The most common indications for renal biopsy were nephrotic syndrome (36.2%, n = 114) and acute kidney injury (20.0%, n = 63). Among primary glomerular diseases (41.5%, n = 115) the most common were IgA nephropathy (26.1%, n = 30) and focal-segmental glomerulosclerosis (17.4%, n = 20) and among secondary glomerular diseases (31.4%, n = 87), lupus nephritis (51.7%, n = 45) and amyloidosis (20.7%, n = 18). Statistical analysis revealed significant correlation between gender and major pathological diagnosis (Fisher’s exact test, p <.01) and between indications for renal biopsy and major pathological diagnosis (χ2, p <.01). Regarding the temporal evolution, no statistically significant differences were found in the number of renal biopsies (χ2, p =.193), number of glomeruli per sample (Fisher’s exact test, p =.669), age (Kruskal-Wallis, p =.216), indications for renal biopsy (χ2, p =.106) or major pathological diagnosis groups (χ2, p =.649). However, considering the specific clinico-pathological diagnoses and their temporal variation, a statistically significant difference (Fisher’s exact test, p <.05) was found for lupus nephritis and membranous nephropathy with an increasing incidence and for amyloidosis with an opposite tendency. Discussion: The review of the native kidney biopsies from a population with particular characteristics, geographically isolated, such as those from Madeira Islands, showed parallel between epidemiological numbers referring to other European subpopulations, allowing simultaneously a comprehensive approach to our renal biopsy policies