Clinicopathological Analysis Based On 177 Renal Biopsies

Objective: To analyse the renal pathological types and clinical manifestations of 177 cases undergoing percutaneous renal biopsy and to explore the relationships between them.Methods: Clinical manifestations and laboratory examinations data were collected from 177 cases with renal biopsy in the second affiliated hospital of Dalian medical university during February 2002 and November 2007. All biopsies were performed under ultra-sound guidance using an automated springloaded gun device. Renal biopsies were processed for light and immunofluorescence microscopy in all specimens and for electron microscopy in some specimens. In all cases, sections were stained with Hematoxylin and Eosin (H and E), Masson's trichrome, periodic acid-Schiff (PAS), and Silver Jone's stain. Then, pathological diagnosis were made according to the WHO criteria of 1982 for renal pathology or the modified WHO criteria of 1995.Results: The mean age at renal biopsy was(34.4±13.3)years in 177 patients with renal diseases. A high incidence rate (55.7%) of this group patients occurred at the age from 20 to 39 years. The ratio of male to female was 1:1.1. In these patients with renal diseases, glomerular disease patients are dominant (98.9%). Primary glomerular diseases accounted for 76.9% of all patients, and secondary glomerularphritis 22.0%. Nephrotic syndrome was the most frequent clinical type (52.2%) of primary glomerular diseases, followed by latent glomerulonephritis (25.0%),chronic glomerulonephritis (20.6%) and acute glomerulonephritis (2.2%). IgA nephropathy (47.8%) and non-IgA mesangial proliferative glomerulonephritis (23.5%) were predominant pathologic types of primary glomerular diseases. Latent glomerulonephritis was the most common clinical type (41.5%) of IgA nephropathy and nephrotic syndrome was the most frequent clinical ma nifest ation (71.9%) of non- I gA me s angial proli fera tive glomerulonephritis. Secondary glomerularphritis mainly manifested nephrotic syndrome (56.4%). Systemic lupus erythematosus nephritis was the most frequent pathologic type (46.2%) of secondary glomerularphritis, followed by HBV-related nephritis (20.5%) and purpuric nephritis (20.5%). The predominant clinical manifestation of systemic lupus erythematosus nephritis and HBV-related nephritis paients was nephrotic syndrome, and the most common clinical manifestation of purpuric nephritis paients was latent glomerulonephritis.Conclusion: Both the clinical and pathological types of kidney dieases have many varities. There are certain relationships between clinical manifestations and pathological types. But it's difficult to find positive relationship between them. Renal biopsy is necessary to identify the pathological type of kidney disease.