Clinical And Pathological Analysis Of275Cases Of Elderly Patients With Kidney Disease

Objective:Through retrospectively analysing the data of the clinical manifestations andpathology types of275elderly patients with kidney disease, define the distributionand features of the renal biopsy pathology type of the elderly patients. Explore thelinks between clinical manifestations and pathological type. Further more to discussthe value of biopsy in elderly kidney disease.Method:A retrospective analysis of hospitalization elderly patients (≥60years of age)who had the renal biopsy operations in the Second Clinical Hospital of JilinUniversity from March2004to November2012has been made. All the renal biopsyoperations are done by automatical percutaneous biopsy guns ultrasound-guided. Andbiopsy specimens were examined by light microscopy (HE, PAS, PASM and Massonstaining), immunofluorescence and electron microscopic examination (in some cases).The pathological diagnosis were made according to the classification criteria of theglomerular disease WHO (1995). Collect clinical data, pathology and laboratory testsand other indicators of the elderly renal biopsy patients, using SPSS statisticalsoftware to establish a database and analyzed statistically. The data between thegroups were compared using the x2test, measurement data were compared usinganalysis of variance, P <0.05was considered significant meaning.Results:We obtain a total of275cases of kidney tissues from275patients of which thesuccess rate is100%.The average age of the group of275elderly patients with kidneydisease is(64.9±3.4) years, including155male patients,120female patients of which the male to female ratio of1.3:1. In this set of data,the highest proportion (93.5%) isglomerular disease(257of275),of which a total of180cases are primary glomerulardisease, accounting for65.5%and secondary kidney disease in95cases, accountingfor34.5%. Among the cases of secondary kidney disease, there are77cases ofglomerular disease (28%),12cases of renal vascular disease(4.4%) and6cases oftubulointerstitial nephropathy(2.2%). The most common clinical manifestations ofprimary glomerular disease are nephrotic syndrome, accounting for53.3%, followedby chronic renal failuer (23.4%) and chronic glomerulonephritis (17.2%). The mostcommon pathological types are membranous nephropathy (41.7%), followed bymesangial proliferative glomerulonephritis (17.2%), IgAN(13.9%), FSGS(11.1%),MCD(8.3%), MPGN(3.3%). Nephrotic syndrome(30.5) is the most common clinicalmanifestations of secondary kindey disease,of which acute renal failure(23.2%) andchonic glomerulonephritis (22.1%) follows. The most common pathological types ofsecondary kindey disease are lupus nephritis()16.9%and renal amyloidosis (14.7%)followes. Diabetic nephropathy accountes for13.7%, purpura nephritis accountes for12.6%, hypertensive renal disease(10.5%) and tubulo-interstitial nephritis(6.3%) alsocontributes.Conclusion:1. The clinical manifestations and pathological types of kidney disease are varied.Through the analysis of the data, there are some connections between the clinicalmanifestations and pathological types of kidney disease, but we are not able to find anabsolute one-to-one correspondence.2. In elderly kidney disease etiology, primaryglomerular disease dominates.The more common pathological types are membranousnephropathy (MN)， IgA nephropathy IgAN and mesangial proliferativeglomerulonephritis(MsPGN).3.As secondary glomerular diseases, amyloidosisnephropathy, diabetic nephropathy, lupus nephritis are common pathological types.4.Either primary glomerular disease or secondary glomerular diseases, the mostcommon clinical manifestations is nephrotic syndrome.5. As elderly kidney patients,under the premise of the indications of renal biopsy should be possible to perform a renal biopsy surgery, which plays a vital role in diagnosing, guiding treatment andjudge prognosis.