Clinical and pathological characteristics of patients with acute kidney injury in Japan in whom kidney biopsy was performed: a cross-sectional analysis of the Japan Renal Biopsy Registry (J?RBR)
Clinical and pathological characteristics of patients with acute kidney injury in Japan in whom kidney biopsy was performed: a cross-sectional analysis of the Japan Renal Biopsy Registry (J?RBR)
复制标题
日本进行肾活检的急性肾损伤患者的临床和病理特征：日本肾活检登记处（J?RBR）的横断面分析
DOI：
10.1007/s10157-022-02236-7
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发表时间：
2022
影响因子：
2.3
通讯作者：
the Committee for Renal Biopsy and Disease Registry of the Japanese Society of Nephrology
中科院分区：
文献类型：
--
作者：
Moniwa Norihito;Tanaka Marenao;Sato Hiroshi;Shimizu Akira;Sugiyama Hitoshi;Yokoyama Hitoshi;Tsuruya Kazuhiko;Hashiguchi Akinori;the Committee for Renal Biopsy and Disease Registry of the Japanese Society of Nephrology
急性肾损伤（AKI）是一个全球关注的问题，它会导致预后不良或终末期肾脏疾病。本研究的目的是利用日本肾活检登记处（J-RBR）的数据，阐明肾活检患者的特征。方法筛选2007年至2018年在J-RBR中登记的38351例病例。我们根据临床诊断获得383例AKI患者的数据进行分析1，根据病理诊断获得714例急性间质性肾炎（AIN）或急性肾小管坏死（ATN）患者的数据进行分析2。结果在筛选的病例中，383例AKI患者（1.0%）纳入分析1。AKI的主要病理诊断为AIN、ATN、慢性间质性肾炎、肾硬化和新月形肾小球肾炎。在筛选的病例中，589例AIN患者（1.5%）和110例ATN患者（0.3%）被纳入分析2。AIN的临床诊断主要为AKI、快速进展性肾小球肾炎（RPGN）、慢性肾病综合征（CNS）和药物性肾病（DIN），而ATN的临床诊断主要为AKI、RPGN、DIN和CNS。ATN患者血清肌酐水平高于AIN患者。结论J-RBR中临床诊断AKI病例占1.0%，病理诊断AIN病例占1.5%，ATN病例占0.3%。对于怀疑为内源性AKI的患者，应行肾活检以明确病因并选择适当的治疗方法。
IntroductionAcute kidney injury (AKI) is a worldwide concern and it leads to a poor prognosis or end-stage kidney disease. The purpose of this study was to clarify the characteristics of patients with AKI in whom kidney biopsy was performed using data of the Japan Renal Biopsy Registry (J-RBR).MethodsWe screened 38,351 cases that were registered in the J-RBR from 2007 to 2018. We obtained data for 383 patients with AKI based on clinical diagnosis for analysis 1 and data for 714 patients with acute interstitial nephritis (AIN) or acute tubular necrosis (ATN) based on pathological diagnosis for analysis 2.ResultsOf the cases screened, 383 patients with AKI (1.0%) were included in analysis 1. The main pathological diagnoses of AKI were AIN, ATN, chronic interstitial nephritis, nephro-sclerosis and crescentic glomerulonephritis. Of the cases screened, 589 patients with AIN (1.5%) and 110 patients with ATN (0.3%) were included in analysis 2. The main clinical diagnoses of AIN were AKI, rapidly progressive glomerulonephritis (RPGN), chronic nephritic syndrome (CNS) and drug-induced nephropathy (DIN), whereas those of ATN were AKI, RPGN, DIN and CNS. ATN patients had a higher serum creatinine level than that of AIN patients.ConclusionOur results revealed that cases in the J-RBR included 1.0% of AKI cases based on clinical diagnosis and 1.5% and 0.3% of AIN and ATN cases, respectively, based on pathological diagnosis. In patients with suspected intrinsic AKI, kidney biopsy should be performed for diagnosis of the precise etiology and selection of appropriate treatment.