[Epidemiology of biopsy-proven renal disease in Romania: data from a regional registry in north-eastern Romania].

Unlike Western European countries, data on the epidemiological biopsy-proven renal disease in Eastern Europe is scarce. We aimed to analyze retrospectively the main histological renal findings, over a 10-year (1995-2004) period, in a large tertiary nephrology referral center in North-Eastern (N-E) Romania, serving a population of 4.7 million inhabitants. Clinical and biological data were also collected and correlated with histological findings. 336 renal biopsies were finally analyzed. The distribution of major clinical syndromes was: nephrotic syndrome (52%), followed by acute renal failure (19%), mild-to-moderate chronic renal failure (17%), nephritic syndrome (8%) and asymptomatic urinary abnormalities. 56.6% and 32.2% were primary and secondary glomerulopathies (GN), respectively, whereas vascular nephropathies and tubulointerstitial nephritis accounted for only 3.6 and 2% of the diagnoses. Overall, membranoproliferative (MPGN) (38%) and mesangioproliferative (MesGN) GN's (19%) were the most common primary glomerulopathies. A progressive significant decrease in the incidence of MPGN and an increase in MesGN over time were seen in our center. Analyzing other Romanian regional data, also a geographical "shift" in the prevalence of the most common primitive GN's from Eastern (E) to Western (W) Romania, similar to the N to S gradients across Europe was noted: there is a high prevalence of MPGN in the E, and a high prevalence of MesGN (including IgA nephropathy) in W Romania. These important differences in the prevalence of the most common primary GN's in E Romania may be due to lower income, education, and infrastructure levels. This hypothesis is strengthening by the higher prevalence of post-infectious and, possible, vasculitis-related GN in E Romania.