| Objective To analyze the demographic characteristics,pathological types,and the relationship between clinical manifestations and pathological types of patients with renal biopsy in our center,and to explore the evolution trend of renal disease spectrum in recent 12 years.Methods The method of retrospective analysis was used.The demographic,clinical and pathological data of patients who underwent renal biopsy in the Department of Nephrology of Ning Xia Medical University General Hospital from August 2008 to December 2019 were analyzed.They were divided into two groups according to the time of renal biopsy(1501 cases from 2008 to 2013 and 2366 cases from 2014 to 2019).According to the age of renal biopsy,they were divided into 4 groups(less than and equal to 18 years old,19-40 years old,41-59 years old,more than and equal to 60 years old)."more than and equal to 60 years old" was defined as "old age".Results 1.A total of 3867 patients with renal biopsy were included in this study,most of them were male(53.71%).The average age was(39.59 ±14.05)years old.The high incidence age of renal disease was 19-40 years old(46.55%).The proportion of elderly patients with renal biopsy showed an increasing trend(P<0.05).The most common clinical manifestation in renal biopsy is nephrotic syndrome(36.33%).2.Primary glomerular disease(PGD)is the main body of renal disease(78.79%),followed by secondary glomerular disease(SGD),tubulointerstitial disease(TIN)and hereditary nephropathy,which accounted for 18.57%,1.45% and 1.19% respectively.In PGD,Ig AN(44.60%)is the most common,followed by MN(30.75%).In SGD,Henoch-Schonlein purpura nephritis(HSPN)was the most common(27.44%),followed by lupus nephritis(LN)(25.07%).3.Compared with 2008-2013,the average age of renal biopsy patients in2014-2019 increased(41.22±13.944 vs 37.02±13.829,P<0.01).The proportion of PGD showed a downward trend(77.04% vs 81.55%,P <0.01),SGD(19.82% vs 16.59%)and the proportion of TIN(1.79% vs 0.93%)showed an upward trend(P<0.05).The proportion of MN in PGD increased(34.50% vs 25.17%,P<0.0l),and the proportion of Ms PGN(non-Ig A deposition)decreased(3.89% vs 8.91%,P<0.01).In SGD,the proportion of diabetic nephropathy(DN,22.82%vs 6.03%)and hypertensive renal damage(HTN,12.79%vs 5.22%)increased(P<0.0l),while the proportion of HSPN(20.47% vs 40.56%)and hepatitis B virus associated glomerulonephritis(HBV-GN,3.84%vs18.88%)decreased(P<0.01).4.Compared with 2008-2013,the proportion of patients with clinical manifes tations of AKI(4.31%vs1.53%),CRF(8.07%vs2.99%),simple hemauria(3.13%vs1.67%)and 24-hour urinary protein≤1.0g(27.63%vs19.63%)at renal biopsy from 2014 to 2019 increased(P<0.0l),while the proportion of patients with NS(32.54%vs42.31%)decreas ed(P<0.0l).During renal biopsy,the proportion of CRF(28.04%vs0.00%,P<0.01)incr eased in patients with DN,while the proportion of patients with proteinuria and hemat uria decreased(27.10%vs66.66%,P<0.01).Conclusions 1.The high incidence population of renal disease in Ning Xia area is young and middle-aged male,the average age of renal biopsy shows an increasing trend,and the proportion of elderly patients with renal biopsy increases.2.PGD is still the dominant kidney disease in this area,and the proportion of SGD and TIN has increased in recent 6 years.In PGD,Ig AN is still the most common,the proportion of MN increases,and the age of onset tends to be younger.HSPN was the most common in SGD,the proportion of LN,DN and HTN increased,while the proportion of HSPN and HBV-GN decreased.In recent 6 years,the proportion of LN surpassed HSPN,to become the most common SGD.3.The clinical manifestations were increased acceptance of renal biopsy in patients with simple hematuria and 24-hour urinary protein ≤ 1.0g and diabetic nephropathy.We should strengthen the management of metabolic diseases(diabetes,hypertension)in Ning Xia area,and pay more attention to the patients with mild abnormal urine test. |
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