Analysis Of Clinical And Pathological Characteristics In 196 Pediatric Patients With Renal Biopsies

Objective Our study aims to summarize the clinical and pathological features of pediatric patients with renal biopsy,to understand the complications,indications and contraindications of renal biopsy,explore the relationship between clinic and pathology of renal disease,ultimately provide the basis for diagnosis and therapeutic interventions of children patients.Methods 196 pediatric patients with renal biopsy who were admitted to the Department of Pediatrics The First Affliated Hospital of Guangxi Medical University during the period January 2005 to January 2016 were recruited to our study,and their clinical and pathological information were analyzed retrospectively.Results(1)Among 196 patients with renal biopsy,123 cases of males(62.8%): 73 cases of females(37.2%)=1.68:1,and a median age was(10.81±2.41)years(rang 4.58-15.92).Primary glomerular disease(PGD)was120 cases(61.2%),followed by 74 cases(37.8%)of secondary glomerular disease(SGD)and 2 cases(1.0%)of hereditary kidney disease.(2)Clinic: The main clinical manifestation in PGD is nephrotic syndrome(NS)(96 cases,80%),followed by hematuria and proteinuria(10 cases,8.3%),isolated hematuria(6cases,5%).In SGD,the most common clinical manifestation is NS(40 cases,54.1%),followed by hematuria and proteinuria(21 cases,28.4%),isolated proteinuria(10 cases,13.5%).(3)Pathology: IgA nephropathy(32 cases,26.7%)is the most common pathological type of PGD,followed by mesangial proliferative glomerulonephritis(25 cases,20.8%),glomerular minor lesion(24cases,20%).In SGD,lupus nephritis(LN)were 32 cases(43.2%),the pathological classification is given priority to with type IV(13 cases,40.6%);followed by Henoch-Schonlein purpura nephritis(HPSN)were 32 cases(43.2%),pathology classification to grade IIb to see(13 cases,40.6%);Hepatitis B related membranous nephropathy(HBV-GN)were 10 cases(3.5%),and membranous nephropathy(8 cases,80%)was the most common histology type.(4)Correlation analysis: There was correlation between the clinical manifestations and pathological features in PGD.When NS as the main clinical manifestations,glomerular minor lesion,mesangial proliferative glomerulonephritis and Ig A nephropathy were the main pathological types of PGD,while hematuria and(or)proteinuria as the main clinical manifestations,IgA nephropathy was the main histology type.There is no significant correlation between clinical presentations and pathological features in SGD.(5)Complications of renal biopsy: Among 196 patients with renal biopsy,71 cases(36.2%)had complications,the most common “chief complaint” was perirenal hematoma(51cases,26.0%),followed by gross hematuria and gross hematuria with perirenal hematoma(8 cases,4.1%,respectively)Conclusions(1)A higher success rate could be obtain by ultrasound guided renal biopsy in pediatric patients,which characterized by simple operation and little damage to kidney.(2)In our study,NS and hematuria with proteinuria were the main clinical manifestations of children with glomerular disease and their pathological types were various.(3)LN,HSPN and HBV-GN are common typesof SGD in children,and their clinical manifestations,pathological types and pathological grades were multifarious.There was no corresponding relationship between clinical presentations and pathological characteristics of SGD.(4)Complications were infrequent in pediatric patients who subjected to renal biopsy.Among the complications,give priority to hemorrhagic symptom,and other serious complications had not been in our investigation.