Characteristic Of The Histological Spectrum Of Glomerular Diseases In The Past10Years Of The First Affiliated Hospital Of Zhejiang University

Obj ective Between January2004and December2013in the First affiliated hospital of Zhejiang University,6687attempts of percutaneous renal biopsy were performed in renal patients. In this study, the pathologic entities were retrospectively analyzed, and the pathologic demography between2004-2008and2009-2013was compared to find out the differences of spectrum and for the diagnose, treatment, and prevention of kidney disease in future.Methods Pathological classifications were made according to the WHO criteria of1995by a panel of nephrologists and pathologists in routine clinical-pathological rounds. Finally we analyzed the characteristic and changes of the spectrum of glomerular diseases in the past10years. Results A total of6687cases were analyzed in the past10years, including2324cases in2004-2008and4363cases in2009-2013. The most frequent glomerular disease was primary glomerular nephropathy (83.58%) followed by secondary glomerular nephropathy (13.94%), then were tubulointerstitial disease (1.59%) and hereditary nephropathy (0.15%). The comparison of spectrum in before and later five years indicated that primary glomerular nephropathy decreased, secondary glomerular nephropathy significantly increased (P<0.05) while tubulointerstitial disease and hereditary nephropathy kept stable during ten years. In primary glomerular nephropathy, IgA nephropathy (IgAN) was the most common type (53.91%), followed by membraneous nephropathy (MN)(17.93%), minimal change disease (MCD)(7.57%), Mesangial Proliferative Glomerulonephritis (MsPGN)(7.50%), Glomerular Minor Lesion (GML)(4.33%), Sclerosing glomerulonephritis (2.93%), Focal Segmental Glomerulosclerosis (FSGS)(2.04%), while the cases of Focal Glomerulonephritis (FGN), Membranoproliferative Glomerulonephritis (MPGN) and Crescentic Glomerulonephritis (CrGN) were only a little. The comparison of before and later five years showed that membraneous nephropathy (MN), Focal Segmental Glomerulosclerosis (FSGS), minimal change disease (MCD), IgA nephropathy (IgAN) significantly increased (P<0.01) while Glomerular Minor Lesion (GML), Mesangial Proliferative Glomerulonephritis (MsPGN) obviously decreased (P<0.01). In secondary glomerular nephropathy, lupus nephritis (LN)(40.88%) was the most common type, then were Henoch-Schonlein Nephritis (HSN)(17.81%), renal lesion secondary to Systemic Vasculitis (SV)(10.73%), Diabetic Nephropathy (DN)(9.98%) and monoclonal immunoglobulinopathy of secondary glomerular nephropathy (7.09%). The percentage of LN in later five years was significantly lowered than before five years (P<0.05) while Diabetic Nephropathy (DN)(9.98%) and monoclonal immunoglobulinopathy of secondary glomerular nephropathy were obviously higher than before (P<0.05).Conclusion This report was the first analysis of the histological findings by renal biopsy in the First affiliated hospital of Zhejiang University. The findings showed that primary glomerular nephrology was the most frequent type in all specimens and IgAN was the predominant type of it all the time. The prevalence of secondary glomerular nephrology was increasing in the later five years and of it LN was the most common type. Numbers of DN and monoclonal immunoglobulinopathy of secondary glomerular nephropathy were increasing in the later five years. This report indicated the spectrum and changes of kidney diseases proven by renal biopsy in the First Affiliated Hospital of Zhejiang University which was a typical example in Zhejiang Province. It would play an important role in clinical work and the study of epidemiology.