A Clinico-pathological Analysis Of 1773 Renal Biopsies

Objective to investigate the clinical presentations and the pathological patterns of renal biopsy patients as well as their relationships.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 Fisrt Affiliated Hospital of Chongqing Medical University and analyzed the pathological patterns according to gender,age and the clinical presentations.Results 1773 patients were recruited in this study,male:females ratio=1:1.13,the average age was 43.24± 13.78y.① Primary glomerulonephritis(PGN),secondary glomerulonephritis(SGN),tubulo-interstitial nephropathy(TIN)and hereditary glomeruler diseases(HGD)accouted for 77.8%,20.8%,1.3%and 0.1%of the total cases.The proportion of PGN was found to be higher than other pathological patterns in the young,middle-aged and elderly group,but the constitute ratio of PGN and SGN had no statistical significance in the three aged groups(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 lupus 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 statistical significance in the three aged groups(P=0.000).IgAN was the most common pathological pattern in the young group and the middle-aged group,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 pattern of nephrotic syndrome and Chronic glomerulonephritis were MN and IgAN,respectively.④The constitute ratio of SGN,s all pathological patterns had statistical significance in the gender(P=0.000).The proportion of woman was higher than man in LN.The proportion of man was higher than woman in HSPN,HBV-GN and diabetic nephropathy(DN).⑤The most common pathological gradings of LN and HSPN were IV and IIIB,respectively,and the most common pathological pattern of HBV-GN was MsPGN.Conclusions The pathological patterns of nephropathy had some relationships with age,gender and clinical presentations,but not yet constituted a regular correspondence.Therefore nephropathy patients should not just limit to clinical diagnosis,also should finish renal biopsy to make pathological pattern and pathological grading clearly,which could guide treatment and improve prognosis.