The Pathological And Clinical Analysis Of 7273 Cases Of Glomerular Diseases In Shandong Province

Background:K idney disease is a common and frequently-occurring disease that harms human health.With the aging and deepening of the population degree,the proportion of End stage renal disease(ESRD)increased year by year which badly harms the human health,bringing great burden to both the society and the family.As the major cause of end-stage renal disease in China,knowing the epidemiological distribution of Glomerular disease(GD)is very important for the prevention and treatment of ESRD.Glomerular diseases can be divided into primary,secondary and hereditary diseases,with different pathological types and different treatment regimens.The purpose of this study was to investigate the clinical and pathological characteristics of glomerular diseases in Shandong Province in recent years.Objective:To analyse the pathological types,clinical features and epidemiological distribution of glomerular diseases and the changing trends of its pathological types.Method:A total of 7273 patients with percutaneous renal biopsy admitted to the Department of Nephrology of Shandong Provincial Hospital from January 2011 to May 2020 were collected.The pathological data were examined by light microscopy,immunofluorescence and electron microscopy in the Institute of Pathology,School of Medicine,Shandong University.Combined with clinical data and laboratory results,the pathological data were collected to learn The clinical and pathological characteristics of glomerular diseases.Results:The age range of 7273 patients with glomerular disease ranged from 0 to 81 years old,with a median age of 39.Most of the patients were male.PGD(81.53%)was the most common disease type,followed by SGD(18.18%).Among them,the majority of PGD patients were male(56.66%,male:female=1.31:1),while the majority of SGD patients were female(54.84%,male:female=0.82:1).The three most common pathologic types of PGD were MN(48.01%),IgAN(25.05%),and MCD(18.25%),among which the incidence of MN showed an increasing trend year by year since 2011,rising from the lowest 31.42%(2011)to 59.06%(2018),and stabilized at more than 50%in the following two years.In terms of clinical laboratory indicators,the 12 pathological types of PGD generally showed a one-to-one inverse correlation between the levels of Alb and urinary albumin,while the levels of MCD and IgMN showed a low level of urinary albumin while the levels of Alb were very low.MCD and IGMN were also the two pathological types with the least occurrence of hematuria(40.62%and 46.88%).On the contrary,the pathological types with the most frequent occurrence of hematuria were ENPGD(100%),CREGN(94.12%)and C3N(90.00%).Among 1322 SGD cases,the five most common pathological types were as follows:Lupus nephritis(477 cases,36.08%),purpura nephritis(271 cases,20.50%),diabetic nephropathy(167 cases,12.63%),hypertension associated renal damage(140 cases,10.59%),hepatitis B virus associated nephritis(134 cases,10.14%).Conclusions:1.In Shandong Province,glomerular diseases generally occur in young and middle-aged males.On the contrary,SGD tends to occur in women.2.MN is the most common pathologic type of PGD in Shandong Province,and its incidence has been increasing year by year since 2011.3.MPGN was the pathological type with the highest level of proteinuria,while MCD and IgMN were the pathological type with the lowest level of proteinuria and hematuria.The most common pathological types of hematuria were ENPGD,CREGN and C3N.4.LN is the most common SGD pathological type in Shandong Province,and it is more common in young females;HSPN is the second most common type of SGD after LN,and it mainly occurs in male children.DN and HN were the most common in middle-aged and elderly patients.