Clinical Analysis Of Histologic Grading And Tubulointerstitial Lesions In IgA Nephropathy

Objective:To analyze the characteristics of prevalence and pathological type of biopsy-proven kidney disease on the cases in General Hospital of P.L.A. Methods: Among all of the 1954 biopsy-proven cases reviewed, 1795 cases were adults and 159 cases were children. Results: 1.General analysis: Among all biopsy-proven cases of adults and children, the incidence of glomerulonephritis( ON )was respectively 97.8% and 96.2%, while the incidence of tubulointerstitial Disease (TID) was only 2.2% and 3.8%. Among the ON of adults, the primary glomerulonephritis ( PGN ) was the most common finding and it occupied 77.9 %, the second glomerulonephritis (SON) was 21.7 % and the hereditary nepbritis (HERN) was 0.4 %. The incidence of pediatric PGN was 11.2% lower than that of adults, but its SGN was10.6% higher than that of adults and no HERN was found in children. 2.Analysis of the PGN:No matter adults or children, the incidence of males was higher than that of females. Its proportion was 2.53:1 and 2.38:1 respectively. The age of high incidence of the PGN was mostly between 15 to 34 years old, but for the membranous nephropathy (MN) , it was between 45 to 54 years old. The incidence of the IgA nephropathy (IgAN) and the mesangial proliferative glomerulonepbritis (MsPGN) was among the highest in both adults and children, it was respectively 43.7% /40.2% and 28.7%27.5%. Compared 1994-1999 with 1987-1993, the incidence of the IgAN, MsPON and Crescent glomerulonephritis (CREGN) was increased by 7.1%, 2.9% and 1.3% respectively, while that of other PGNs was decreased by 1 O/o~~2%. The chronic glomerulonephritis ( CON) and the nephrotic syndrome ( NS) were the most common symptoms in both PONs of adults and children, respectively accounted for 63.7%/46.1% and 31.4%/38.2%. 3. Analysis of the SGN: The proportion of males to females was 0.49:1, for adults' SON. The most common finding SON was the lupus nephritis (LN), and the second was the Hepatitis B virus associated with the nephritis, Henoch-Schonlein purpura nephritis and Diabetic nephritis. Among adults' SON, the age of high incidence was between 15 to 34 years old, while that of the metabolic disease was middle or old age. Among children's SGN, the highest was the Henoch-Schonlein purpura nephritis (68.6%) , and the second was Hepatitis B virus associated with the nephritis and LN. No metabolic disease was found. 4. Among adults' TID, the most common finding was the acute or chronic interstitial nephritis (74.4%) , and the second was the acute tubular necrosis (12.9%) . The clinical symptom of 25.6% of TID was renal tubular acidosis. The main cause of the TID was21medicine. Conclusion: The most common reason for the biopsy-proven cases was GN, while the TID only accounted for a very low percentage. The PGN was more common GN, it frequently occurred on~ males. The main clinical type was CGN and NS. The IgAN and MsPGN were the two among the most commonly finding PGN. The LN was the most common SGN of adults. The primary pathogenesis of pediatric SGN was Henoch-Schonlein purpura nephritis. The Hepatitis B virus associated with nephritis was the second SGN, both occurred in adults and children. The patients of high incidence of GN and TID were young. The interstitial nephritis was the most common TID. The main reason for TID was medicine.