| Background:The prevention and treatment of chronic kidney disease has become an important public health problem faced by countries around the world.In recent years,the prevalence of chronic kidney disease has increased significantly.Therefore,clarifying the cause of kidney disease as early as possible can delay the progression of CKD and reduce the incidence and mortality of ESRD.At present,renal biopsy is still the "gold standard" for the diagnosis of kidney disease.A number of studies have shown that the proportion of kidney pathological types of primary glomerular disease is constantly changing in recent years,but the situation in Northeast China has not been reported.Therefore,to understand the characteristics of the pathological types and epidemiological rules of kidney diseases in Northeast China.It has guiding significance for the diagnosis and treatment of kidney disease.In order to be able to deeply analyze the changes in the pathological types of kidney diseases in Northeast China,we collected 3899 clinical and pathological data of the First Hospital of Jilin University in the past 8 years.Preliminary understanding of the pathological types and epidemiological laws of kidney diseases in Northeast China will provide a basis for the diagnosis and treatment of kidney diseases.Objective:To analyze the clinical and pathological data of 3899 patients with renal biopsy from January 2012 to December 2019 at the First Hospital of Jilin University,and the changes in the type of renal pathology in the past 8 years,providing a certain basis for the diagnosis and guidance of renal disease.Methods:The clinical and pathological data of 3899 patients undergoing renal biopsy from 2012 to2019 in the First Hospital of Jilin University were retrospectively analyzed.According to the date of pathological diagnosis,patients were divided into 1766 cases in 2012-2015 group and2133 cases in 2016-2019 group.Statistical analysis was performed using SPSS25.0 statistical software.Results:1.Primary incidence: The center had a total of 3899 renal biopsy cases from 2012 to2019,the most of which were primary glomerular disease,with a total of 2822 cases,accounting for 72.3%;followed by secondary glomerular disease,a total of 994 cases,accounting for 25.5%;the third place was renal tubulointerstitial disease,a total of 68 cases,accounting for 1.8%;the smallest was hereditary nephropathy,a total of 14 cases,accounting for 0.4%.2.Age distribution: The mean age at the time of renal biopsy of 3899 patients was 38.52± 18.41 years(3-88 years).Among them,there were 702 cases in the age group of <18,accounting for 18.0%;1194 cases in the age group of 18-39,accounting for 30.6%;1441cases in the age group of 40-59,accounting for 37.0%;562 cases in the age group of ?60,accounting for 14.4%.In patients with membranous nephropathy <60 years old,as age increases,the proportion of primary nephropathy in this age group increases.The last 8 years,the proportion of patients aged ?60 years increased from 12.7% to 15.8%,and the difference was statistically significant(P <0.01).3.Gender distribution: Among the 3899 renal biopsy patients,2227 were male(57.1%)and 1672 were female(42.9%).The male to female ratio was 1.33: 1.In the past 8 years,the proportion of women among 702 children(<18 years)had increased from 41.2% to 49.0%,the difference was statistically significant(P <0.05).4.Pathological distribution of children and 8-year changes: The center had a total of 702 cases of renal biopsy in children with complete data.Among children PGD,IgA nephropathy(143 cases,37.3%)was the most common,followed by minimal change disease(140 cases,36.6%),and membranous nephropathy(27 cases,7.0%).In children SGD,purpuric nephritis(208 cases,67.1%)and lupus nephritis(71 cases,22.9%)were the main pathological types.The most common hereditary nephropathy was Alport syndrome.In the past 8 years,the proportion of lupus nephritis in secondary glomerular disease had increased from 15.1% to31.1%,and the difference was statistically significant(P <0.01).The proportion of purpuric nephritis in secondary glomerular disease had decreased from 72.3% to 61.2%,and the difference was statistically significant(P <0.05).5.Pathological distribution of adult patients(?18 years)and 8-year changes: The center had a total of 3197 adult kidney biopsy cases with complete data.Among adult PGD,membranous nephropathy(1071 cases,43.9%)was the most common,followed by IgA nephropathy(711 cases,29.2%),and minimal change disease(463 cases,19.0%).In adult SGD,purpuric nephritis(89 cases,13.0%)and lupus nephritis(87 cases,12.7%)were the main pathological types,but in the age groups of 40-59 and ?60,diabetic nephropathy was the most common kidney disease.In the past 8 years,the proportion of patients with membranous nephropathy in primary glomerulopathy increased from 35.1% to 51.0%,and the difference was statistically significant(P <0.01).6.The relationship between renal pathological types and clinical manifestations: The common clinical manifestations of 3899 renal biopsy patients were nephrotic syndrome(1964cases,50.4%)and chronic glomerulonephritis(1663 cases,42.6%).Among 1098 patients with membranous nephropathy,the most common clinical manifestations was nephrotic syndrome(903 cases,82.2%);among 854 IgA nephropathy patients,the most common clinical manifestations was chronic glomerulonephritis(622 cases,72.8%).Conclusions:1.Among patients with renal biopsy,patients in the 40-59 age group have the most patients,with more men than women.Over the past 8 years,the proportion of patients aged?60 has increased.2.Membranous nephropathy is the most common pathological type of renal biopsy patients,and its proportion in primary glomerulopathy is increasing.3.The common clinical manifestations of renal biopsy patients are nephrotic syndrome and chronic glomerulonephritis. |
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