Analysis Of Clinical Manifestations And Pathological Characteristics In575Children With Renal Diseases

ObjectiveRenal disease is a common and frequently-occurring disease in children. Clinical manifestations are varied. Its etiology, pathogenesis, course of disease, prognosis is different. So the pathological diagnosis of kidney disease is the most valuable examination method. The purpose of this study is to investigate the connection of clinical manifestations with renal pathology in children’s renal disease, to provide reference basis for clinical diagnosis and treatment.MethodsRetrospective analysis pathological characteristics and clinical manifestations in575patients who underwent renal biopsy in January2009to May2012in the First Affiliated Hospital of Zhengzhou University.Results1. The characteristics of clinical and pathological characteristics in575cases in single center,386cases of male:189cases of femaie=2.04:1, primary renal disease was60.35%(347/575), The main clinical diagnosis is nephrotic syndrome to60.81%(211/347) and37.16%for simple hematuria and (or) proteinuria (129/347),the pathological type is given priority to with minimal change glomerulopathy was32.28%(112/347), followed by IgA kidney disease accounted for24.50%(85/347). Accounted for38.8%(223/575) patients were secondary renal disease, Henoch-schonlein purpura was81.2%(181/223), pathological classification is given priority to with Ⅲ and Ⅱ. Followed by lupus nephritis was13.0%(29/223), pathology classificaton to Ⅳ type to see.2. Pathological types of151cases of simple type nephritic syndrome, minimal change glomerulopathy wad103cases (68.2%), followed by16cases (10.6%) of focal segmental glomerulosclerosis and15cases (9.9%) of membranoproliferative glomerulonephritis, and IgA nephropathy was4cases (2.8%).60cases of nephritis type pathological diagnosis of children with nephrotic syndrome is given priority to with focal proliferative IgA nephropathy.3. Characteristics of clinical and pathological in85cases of primary IgA nephropathy, male(59cases):female (26cases)=2.67:1,72cases (84.7%) of school-age children,13cases (15.3%) of preschool children.47cases (55.3%) with simple hematuria and (or) albuminuria;28cases (32.9%) with Nephrotic syndrome. Pathologic classifications were41cases (48.2%) of grade Ⅲ,27cases (31.8%) of grade Ⅱ.4. Pathological types of129cases with simple hematuria and (or) proteinuria in children, Age≤3years old was16cases (12.4%), aged4～7years old, a total of46cases (35.7%), age≥8years old was67cases, accounting for51.9%, Minor lesions in glomerular disease was41.9%(54/129),38.0%(49/129) of IgA nephropathy, membranoproliferative glomerulonephritis was9.4%(15/129).62children were aged <8years old,a total of32cases of minor lesions in glomerular disease, accounting for51.6%, IgA nephropathy, a total of16cases (25.8%) of IgA nephropathy, However in the67children were aged≥8years old, a total of22cases of minor lesions in glomerular disease, accounted for32.8%, a total of33cases (49.3%) of IgA nephropathy.5. Secondary renal disease was223patients,3cases (1.3%) of aged≤3years old,67cases (30.1%) of aged4～7years old,,153cases (68.6%) of aged≥8years old. Henoch-schonlein purpura was the most common cause of secondary kidney disease as83.41%(181/217) in this study,1case (0.6%) of age≤3years old,58cases (32.0%) of aged4～7years old,122cases (67.4%) of aged≥8years old. Pathologic classifications were64.09%(116/181) of III level. Lupus nephropathy were29cases, the male(6cases):female(23cases)=1:3.8, pathology type:4cases (13.8%) of I type,2cases (6.9%) of II type,4cases (13.8%) of Ⅲ type,14cases (48.3%),of IV type,3cases (10.3%) of V type,2cases (6.9%) of IV type+V type.7cases was hepatitis B virus associated glomerulonephritis, All the patients wre male, pathological types of5cases of atypical membranous nephropathy,2cases of membranoproliferative glomerulonephritis.ConclusionsPrimary glomerular disease is given priority to in575children with renal biopsy, Clinical diagnosis is given priority to with nephrotic syndrome, Pathologic type is given priority to with tiny lesions in glomerular disease and IgA nephropathy. Simple hematuria and (or) proteinuria with the passage of time, the renal pathological damage has a tendency to aggravate gradually. Give priority to with Henoch-schonlein purpura was the most commom cause of secondary kidney disease, pathologic classification is given priority to with Ⅲ,Ⅱ. Child with lupus nephritis pathological classification is given priority to with IV type, men who see you a lot.