Single-center Study On The Distribution Of Pathological Types Of Renal Biopsies In 3590 Patients And The Variation Trend Over 11 Years

Purpose:Pathological examination of kidney biopsy plays an increasingly important role in the diagnosis and treatment of chronic kidney disease(CKD).As a single-center unit with the largest number of kidney biopsy cases per year in Shenzhen,our department reported the pathological analysis of 615 kidney biopsies in 2008.This study aims to analyze the clinical and pathological data of 3590 kidney biopsies in our department since 2008 in Peking University Shenzhen Hospital,and compare them with large samples from other domestic and foreign studies to understand the demographic characteristics,pathological type distribution and the variation trend of composition spectrum of renal diseases in Shenzhen.Methods: The data of patients undergoing renal biopsy from May 2008 to October2019 at Peking University Shenzhen Hospital was collected from the medical record system of the hospital.Data from homepage diagnosis,light microscopy immunofluorescence,electron microscopy,Laboratory Information System(LIS),Picture Archiving and Communication Systems(PACS),and electronic medical record systems(Electronic Medical Record,EMR)were respectively made into six original data forms.After data desensitization(removal of name,ID number,address,phone number,etc.),we cooperated with a third-party data analysis company(Zhihui Technology,Guangzhou)to clean the original data and obtain the final renal biopsy cohort data set.Non-interventional retrospective observation study was used to record patient demographic data and renal biopsy pathological data.Demographic information includes gender,age,etc.The pathological information of kidney biopsy includes admission time,hospital number,pathological diagnosis,description of photoelectric microscope and immunofluorescence results,and time of kidney biopsy.The distribution characteristics of gender,age and pathological type,and the evolution trend of nephropathy spectrum of the patients were analyzed.Also,we compared our results with large samples from other domestic and foreign studies.Results: Among the 3590 renal biopsies,male patients accounted for 52.84% and female patients accounted for 47.16%.The male to female ratio was 1.12:1.The age among them ranged from 13 years old to 86 years old.The average age was37.53±13.08 years old.The majority of patients were 25~44 years old,accounting for60.25%.The gender distribution of renal biopsy patients in different age groups was statistically different(P<0.05).Primary glomerular disease(PGD)constituted the highest proportion,accounting for 78.80%(2829 cases)of all renal biopsy patients.Secondary glomerular disease(SGD)accounted for 19.12%(686 cases),tubularinterstitial disease accounted for 1.81%(65 cases),and other types accounted for 0.28%(10 case).The peak age of onset of PGD and SGD was 25~44 years old.Patients with PGD were mainly male,accounting for 54.37%.Ig A nephropathy(Ig AN)was the main pathological type,accounting for 52.42%(1483 cases),followed by membranous nephropathy(MN),accounting for 21.10%(597 cases).There was no statistical difference between the distribution of pathological types at different stages.Patients with SGD were mainly women,accounting for 54.66%.Lupus nephritis(LN)was the main composition type of SGD,accounting for 43.44%(275 cases),followed by diabetic nephropathy(DN),accounting for 16.43%(104 cases).No significant change was found in the composition ratio of pathological types in SGD at different stages.There were statistically significant differences in gender distribution and age distribution in different subtypes of Ig A nephropathy(P<0.01).However,there was no statistically significant difference in gender distribution and age distribution in different subtypes of LN(P>0.05).Conclusions: Primary glomerular disease is the main component of kidney disease,and the prevalence is highest in young adults(25~44 years old).In general,male patients were more than female.Ig A nephropathy accounted for the highest proportion of primary glomerular diseases,while lupus nephritis had the highest prevalence among secondary glomerular diseases.There was no statistical difference in the distribution of pathological types at different stages.