Analysis Of Clinical And Pathological Features In 537 Cases Underwent Renal Biopsy

In recent years, with the rising incidence, the kidney disease has obtained more and more attention worldwide. Once the kidney disease progress to the end stage, the patients can rely on dialysis or kidney transplant to survival only. Thus we should focus on the treatment of early stage renal disease. While in China, the kidney disease due mainly to the glomerular disease, and the diagnosis and treatment plan of the glomerular disease needs the guidance of pathological examination. Thus renal biopsy is particularly important in the Department of Nephrology. This study investigated the epidemiology characteristics of renal biopsy, pathological type and clinical manifestations in our hospital. And also provide epidemiological data on renal biopsy to Jilin Province.We retrospectively analyzed patients underwent renal biopsy Department of Nephrology in the First Hospital of Jilin University during January 2007 ~ December 2009.All the 537 patients with complete medical records were observed of gender, age, clinical performance and pathology type.Results:①The mean age of renal biopsy was(36.49±14.94) years (the range:9 years old to 76 years old) in the 537 cases, the incidence population concentrated in the (15 ~ 50) years (80.26%). The total incidence rate of the men corresponded the women, but the primary glomerular disease occurred more common in male (52.63%) with male to female ratio 1.11:1, while the SGD occured more common in female (63.73%) with male to female ratio 0.57:1. Kidney disease occurs in young and middle aged men, this was a great impact on the social productive forces, which we should pay more attention to.②The most common disease was the primary glomerular disease (74.30%), followed by secondary glomerular diseases (18.99%), end-stage renal disease (5.54%), tubular-interstitial diseases (0.71%), and hereditary and congenital renal disease (0.18%). Compared to other reports, the incidence of tubular-interstitial disease of our research was low. These diseases were associated more with the drugs now, which patients may be outside the department of Nephrology, suggesting that we should appreciate such diseases.③The most common primary glomerular diseases was IgA nephropathy (37.34%), followed by mesangial proliferative glomerulonephritis (31.33%), membranous nephropathy(13.28%), glomerular minor lesion (6.27%), the focal segmental glomerulosclerosis (4.26%), crescentic glomerulonephritis (3.01%), minimal change disease (2.01%), membranoproliferative glomerulonephritis (1.50%) and endocapillary proliferative glomerulonephritis (1.00%).④The highest incidence of secondary renal disease was lupus nephritis(42.16%), followed by Hen?ch-Sch?nlein purpura glomerulonephritis (37.28%), hepatitis B virus associated glomerulonephritis (9.8%), diabetic glomerulosclerosis (4.9%). China has a high incidence of lupus nephritis, we should focus on the risk factors, pathogenesis, and therapy of lupus nephritis in the future.⑤The most common clinical manifestation was nephrotic syndrome (45.81%), followed by asymptomatic urinary abnormalities (26.26%). Some domestic and international data showed the most common clinical manifestations were asymptomatic urinary abnormalities, and this clinical type is more often found in the medical examination, it suggested that we should strengthen our physical examination of the kidney disease screening.⑥The most common pathological type of the primary nephrotic syndrome was mesangialproliferative glomerulonephritis (41.49%), followed by membranous nephropathy (21.28%).⑦In our study, 25 patients with acute renal failure underwent renal biopsy. The most common pathological type of acute renal failure was crescentic glomerulonephritis Nephritis (48%), followed by mesangial proliferative glomerulonephritis (16%), others such as tubular-interstitial disease, lupus nephritis and the capillary proliferative glomerulonephritis, also caused acute renal failure. These included not only diseases sensitive to the immune inhibitors, but also self-limited diseases only needed symptomatic treatments. Thus to operate renal biopsy to patients with acute renal failure is of important meanings.⑧In this study, 33 patients with chronic renal failure underwent renal biopsy, in which IgA nephropathy (36.36%) and glomerulosclerosis (36.36%) was the most common pathological type, lupus nephritis (9.1%) also occupied a certain proportion. For patients with definite primary disease, we could give them effective treatment of primary diseases, such as immunosuppressive agents to lupus nephritis, which can delay the progress of renal function. In addition, the method could guide the replacement therapy, such as for patients with FSGS, we couldn't operate a renal transplantation on them, because it will relapse immediately after the surgery.Summing up all the reseach, we reach these conclusions: Kidney disease occurs more often in young males. (15~50) years has the high incidence of kidney disease age. The primary glomerular disease is the most common type in renal biopsy. The most common pathological type of the primary glomerular disease is IgA nephropathy. The most common pathological type of secondary glomerular disease is Lupus nephritis. The most common clinical manifestations of renal biopsy is nephrotic syndrome, followed by asymptomatic urinary abnormalities. For patients with acute renal failure and chronic renal failure, renal biopsy can confirm the diagnosis and guide the treatment.