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

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. A higher resolution version of the Graphical abstract is available as Supplementary information.

The effect of an air purifier on aerosol generation measurements during clinical motility testing.

BACKGROUND: Aerosol spread is key to interpret the risk of viral contamination during clinical procedures such as esophageal high-resolution manometry (HRM). Installing an air purifier seems a legitimate strategy, but this has recently been questioned. METHODS: Patients undergoing an HRM procedure at the Leuven University Hospital were included in this clinical study. All subjects had to wear a surgical mask which was only lowered beneath the nose during the placement and removal of the nasogastric catheter. The number of aerosol particles was measured by a Lasair® II Particle Counter to obtain data about different particles sizes: 0.3; 0.5; 1.0; 3.0; 5.0; and 10.0 µm. Measurements were done immediately before the placement and the removal of the HRM catheter, and one and 5 min after. A portable air purifier with high-efficiency particle air filters was installed in the hospital room. KEY RESULTS: Thirteen patients underwent a manometry examination. The amount of 0.3 µm-sized particles was unaffected during the whole procedure. The larger particle sizes (1.0; 3.0; 5.0; and 10.0 µm) decreased when the catheter was positioned, but not 0.5 µm. During the HRM measurements itself, these numbers decreased further. Yet, 1 min after catheter removal a significant elevation of particles was seen, which did not recover within 5 min. CONCLUSIONS & INTERFERENCES: Based on this study, there is no evidence that filtration systems reduce aerosol particles properly during a clinical investigation.