Evaluation Of Electron Microscopy In Pathological Diagnosis Of 2589 Renal Biopsie

Objective:To investigate 2589 patients with renal biopsy epidemiological characteristics and pathological types distribution; To evaluate the role of electron microscopy in pathological diagnosis of renal biopsies.Methods:To retrospectively summarize the renal biopsy data in 2589 cases having underwent renal biopsy. Pathologic diagnosis of electron microscope(EM) was compared with that of light microscope (LM) and immunofluorescence(IF).Will verify the data into the computer, using the EXCEL and SPSS software to establish a database, using SPSS 16.0 software is analyzed.Results:(1) The mean age of the whole group patients was 37.77±16.06 (1-89).And the ratio of male to female was 0.96:1; Primary glomerular diseases(PGD) accounted for 73.46%, secondary glomerulonephritis (SGN) accounted for 25.07%; The PGD in descending order of incidence were membranous nephritis (MN33.23%), MCD nephropathy(21.82%) and IgA nephropathy(18.72%). (2) The SGN in descending order of incidence were lupus nephritis(76.12%), diabetes nephropathy (8.32%), renal vasculitis (3.70%). The ratio of male to female was 1:6.72 in lupus nephritis,pathologic types for IV accounts for most (40.49%) and V (28.34%).(3) Genetic glomerular disease is less, mainly for thin basement membrane nephropathy and Alport syndrome(AS).(4)EM provided essential diagnosis in 17.27%, and EM provided correcting or supplementary information in 23.10%, then EM supported or confirmed the LM plus IF findings in 59.63%;EM provided useful diagnostic information for final diagnosis in 40.36% of renal biopsies.Otherwise the use of LM plus IF alone in pathological diagnosis was 59.64%(X2= 192.35, P= 0.000)Conclusion:(1) In the groups of kidney diseases of our area,rerial diseases often happen in young people, PGD was the most common renal disease, MN is the most common pathological type, followed by MCD nephropathy and IgAN.;The region of membranous nephropathy incidence shows obvious rising trend, and higher than other domestic areas. (2) In the SGN, lupus nephritis is dominant,followed by diabetic nephropathy and renal vasculitis. (3) Genetic glomerular diseases in this study is less, mainly for thin basement membrane nephropathy and Alport syndrome.(4) EM was essential for the renal biopsy of pathology diagnosis. Therefore, renal biopsy specimen should be routinely reserved for EM.