A clinico-pathological analysis of renal biopsies of 1 773 patients

Abstract:

Objective：To investigate the clinical presentation and the pathological pattern of renal biopsy patients as well as their re－lations. Methods：The clinical and pathological data collected from the patients（≥14 years of age） with renal biopsy from January 2008 to December 2016 in the First Affiliated Hospital of Chongqing Medical University and analyzed the pathological patterns ac－cording to gender，age and clinical presentation. Results：Patients of 1773 were recruited in this study，with male and female ratio of 1∶1.13 and average age was （43.24±13.78） years old. ①Primary glomerulonephritis（PGN），secondary glomerulonephritis（SGN），tubulo-interstitial nephropathy（TIN） and hereditary glomeruler diseases（HGD） were accounted for 77.8%，20.8%，1.3% and 0.1%，respectively. The proportion of PGN was higher than other pathological patterns in young，middle-aged and elder groups，but the con－stitute ratio of PGN and SGN in three groups had no statistical significance（P=0.069）. ②IgA nephropathy（IgAN，41.1%） was the most common PGD，followed by mesangial proliferative glomerulonephritis（MsPGN，22.5%） and membranous nephropathy（MN，14.6%）. The top 3 pathological patterns of SGD were 1upus nephritis（LN，36.4%），Henoch-schonlein purpura nephritis（HSPN，20.1%） and HBV-associated glomerulonephritis（HBV-GN，18.5%）. The constitute ratio of PGN’s all pathological patterns had sta－tistically significant differences in the three aged groups（P=0.000）. IgAN was the most common pathological pattern in the young group and the middle-aged group，while MN was the most common pathological pattern in the old group. ③Nephrotic syndrome（40.3%） and chronic glomerulonephritis（34.2%） were the main clinical presentations in PGN. The most common pathological patterns of nephrotic syndrome and chronic glomerulonephritis were MN and IgAN，respectively. ④The constitute ratio of SGN’s all pathological patterns had statistically significant difference in gender（P=0.000）. The proportion of LN in woman was higher than that in man. The proportion of HSPN，HBV-GN and diabetic nephropathy（DN） in man was higher than that in woman. ⑤The most common pathological grading of LN and HSPN was Ⅳand ⅢB，respectively，and the most common pathological pattern of HBV-GN was MsPGN. Conclusion：The pathological pattern of nephropathy has some relations with age，gender and clinical presentation，but don’t form a regular correspondence. Therefore，nephropathy patients should not just limit to clinical diagnosis，but also should finish renal biopsy to make pathological pattern and pathological grading clearly，which can guide treatment and improve prognosis.