The spectrum of biopsy-proven secondary glomerular diseases: A cross-sectional study in China
The spectrum of biopsy-proven secondary glomerular diseases: A cross-sectional study in China
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活检证实的继发性肾小球疾病谱：中国的横断面研究
DOI：
10.5414/cn109115
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发表时间：
2017-11-01
影响因子：
1.1
通讯作者：
Xu, Dongmei
中科院分区：
文献类型：
--
作者：
Wang, Ping;Tang, Lijun;Xu, Dongmei
目的：慢性肾脏疾病（CKD）的频谱分布已被发现随时间而变化。关于继发性肾小球疾病（SGDs）变化谱的信息有限。为了进一步研究SGDs谱的变化，我们进行了横断面研究。方法：2010年6月至2015年5月，山东省37家医院5935例患者参与本研究。研究以1年为间隔，分为5个阶段。患者被分为四个年龄组。结果：在5935例合格标本患者中，1038例（17.5%）被诊断为SGD。狼疮性肾炎（LN）（27.6%）是最常见的SGD，其次是紫癜性肾小球肾炎（HSPN）（21.7%）和糖尿病肾病（DN）（21.6%）。DN患病率呈上升趋势，成为第3期肾活检的主要原因（29.3%）。乙型肝炎病毒相关性肾炎（HBVAN）患者的比例从第2期的14.7%下降到第5期的5.1% （p < 0.001）。淀粉样变性肾病（AN）患者的比例从第1期的2.2%上升到第5期的7.0% （p = 0.088）。儿科患者DN患病率为0.6%，老年患者为40.7% （p < 0.001）。结论：在我们的研究中，SGD是肾活检的第二大原因。SGD谱的分布随时间和年龄的变化而变化。考虑到检测偏倚的可能性，未来需要更大规模的前瞻性队列研究。
Aims: The distribution of the spectrum of chronic kidney disease (CKD) has been found to vary with time. Limited information is available regarding the changing spectrum of secondary glomerular diseases (SGDs). To further investigate changes in the spectrum of SGDs, we performed a cross-sectional study. Methods: From June 2010 to May 2015, 5,935 patients from 37 hospitals in Shandong Province were involved in this study. The study was divided into five periods according to 1-year intervals. The patients were divided into four age groups. Results: Of the 5,935 patients with qualified specimens, 1,038 (17.5%) were diagnosed with a SGD. Lupus nephritis (LN) (27.6%) was the most frequently identified SGD, followed by Henoch-Schonlein purpura glomerulonephritis (HSPN) (21.7%) and diabetic nephropathy (DN) (21.6%). The prevalence rate of DN demonstrated an increasing trend, and this condition became the leading cause of renal biopsy in period 3 (29.3%). The proportion of patients with hepatitis B virus-associated nephritis (HBVAN) decreased from 14.7% in period 2 to 5.1% in period 5 (p < 0.001). The proportion of patients with amyloidosis nephropathy (AN) increased from 2.2% in period 1 to 7.0% in period 5 (p = 0.088). The prevalence rate of DN was 0.6% in pediatric patients and 40.7% in elderly patients (p < 0.001). Conclusions: In our study, SGD was the second leading cause of renal biopsy. The distribution of the spectrum of SGD varied with time and age. Given the possibility of a detection bias, larger prospective cohort studies are needed in the future.