Trends of Biopsy-Proven Kidney Diseases in Romania: A Single-Center Registry Report Spanning 28 Years

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Rationale & Objective: The epidemiologic landscape of biopsy-proven kidney diseases in Romania and its evolution over time are poorly understood. Study Design: Register-based single-center retrospective study. Setting & Participants: Adult native kidney biopsy records between 1996 and 2023 from the registry of the Victor Babeş National Institute of Pathology, Bucharest, Romania. Predictor: Year of biopsy. Outcomes: Histopathological diagnosis. Analytical Approach: Temporal trends in participant demographics and frequency of histopathological diagnoses were evaluated using regression analyses. Results: We identified a total of 1,937 adult native kidney biopsy records. The median age at diagnosis was 46 years (IQR, 33-58 years), and men represented 54.5% of participants. Immunoglobulin A nephropathy was the most common diagnosis (15.4%), followed by membranous nephropathy (12.5%), focal segmental glomerulosclerosis (8.3%), minimal change disease (8.2%), lupus nephritis (7.0%), and diabetic nephropathy (6.9%). Our results indicate a change in demographic composition of the population biopsied, reflected in an increase in the median age at biopsy over time, and a decrease in the male proportion in recent periods. We identified historically increasing immunoglobulin A nephropathy and diabetic nephropathy frequencies, and decreasing membranous nephropathy and minimal change disease frequencies, which stabilized over more recent periods. In contrast, lupus nephritis registered an increasing trend that was maintained in recent times. Limitations: This is a single-center study and does not report on the clinical data of the participants. Conclusions: Our findings, corroborated with those of other centers in Romania, suggest that kidney disease trends in the Romanian population largely align with those reported in other European registries. However, we echo concerns voiced in other biopsy registry studies, regarding the challenges encountered in attempting direct comparisons between published reports within and across countries.

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