Clinicopathological features of pateints undergoing percutaneous renal biopsy of native kidneys: Ten-years review of a single center / 第二军医大学学报

ABSTRACT

Objective To analyze the epidemiological changes, clinical features and disease patterns of 10-year renal biopsy series in our center and to compare the changes of pathological diagnosis spectrum of renal biopsy, so as to explore the trend of epidemiological characteristics of renal biopsy across ten years. Methods From January 2007 to December 2016, 1 786 patients (aged ≥18 years) undergoing percutaneous renal biopsy were involved and divided into 3 period groups according to the date of biopsy, earlier group (2007-2010), mid-term group (201 1-2013) and recent group (2014-2016). The patients were also divided into 3 age groups (15-39 years, 40-64 years and ≥65 years). The clinical and pathological data of all patients were collected, and than statistical analysis was performed by SPSS 18. 0 software. Results A total of 1 786 cases with complete clinical data were enrolled, of which 973 were male and 813 were female, with a median age of 42 years (range 15-88 years). There were 1 548 patients with primary glomerular disease, with IgA nephropathy (IgAN) being the most common one, accounting for 29.1% (520/1 786), 17.3% (309/1 786) having minimal change disease (MOD), and 17.0%(304/1 786) having membranous nephropathy (MN). Totally 238 patients had secondary renal disease, of which lupus nephritis was the most common one, accounting for 3.4% (61/1 786), followed by diabetic nephropathy (2.9%, 51/1786) and Henoch-Schönlein purpura nephritis (2.2% 39/1 786). There were no significant differences in gender or age between three period groups. Compared with the earlier group (66/684, 9. 6%), the proportions of MN in the midrtem group (90/547, 16.5%) and the recent group (148/555, 26.7%) were significantly increased (P<0.01). Nephritis syndrome (NS; 45.5%, 812/1786) was the most frequent clinical manifestation in all cases, followed by nephrotic syndrome (688/1786, 38.5%). The most common clinical manifestation in patients suffered from NS was MCD in 15-39 years group and MN in 40-64 years group and ≥65 years group. Meanwhile, the most common diagnosis for patients suffered from nephritis syndrome was IgAN in 15-39 years group and 40-64 years group, but was MN in ≥65 years group. Conclusion IgAN remains the most common glomerulopathy in our study. However, the prevalence of MN has grown quickly in recent years. IgAN is the main diagnosis for young and middle aged patients with nephritis syndrome, while the MN is the main for middle aged and elderly patients with NS.