Clinical and Pathological Analysis of 4910 Patients Who Received Renal Biopsies at a Single Center in Northeast China

Abstract

Purpose: To identify the epidemiology and pathological types of kidney diseases and their changes during the past decade, in a population from Northeast China.

Methods: We retrospectively analysed clinical and renal pathological data from 4910 patients who received renal biopsies in the Second Hospital of Jilin University from 2008 to 2017.

Results: Males received more renal biopsies than females (p < 0.001). The average age (p < 0.001) and percentage of elderly patients (p < 0.001) increased over time. The pathological types were primary glomerulonephritis (PGN, 73.2%), secondary glomerulonephritis (SGN, 23.7%), tubular-interstitial nephropathy (TIN, 2.8%), and hereditary nephropathy (HN, 0.3%). The most common forms of PGN were membranous nephropathy (MN, 37.2%) and IgA nephropathy (IgAN, 29.9%). Over time, the prevalence of IgAN decreased, but the prevalence of MN increased. MN was more common in middle-aged and elderly patients, but IgAN was most common in young adults. Analysis of SGN data indicated that lupus nephritis (LN, 34.0%), Henoch-Schönlein purpura glomerulonephritis (HSPN, 17.9%), and diabetic nephropathy (DN, 11.7%) were the most common forms. Over time, the prevalence of DN (p = 0.003), hypertension-associated renal damage (p = 0.005), and systemic vasculitis-associated nephritis (SVARD, p < 0.001) increased, but the prevalence of HSPN (p < 0.001) and hepatitis B virus-associated glomerulonephritis (HBV-GN, p = 0.001) decreased. Nephrotic syndrome was the main clinical manifestation of PGN.

Conclusion: From 2008 to 2017, renal biopsies were increasingly performed in the elderly. There were notable changes in the epidemiology and pathological types of kidney disease among renal biopsy patients at our centre.

Figure 1

Percentages of patients diagnosed with kidney diseases who were in different age groups during different periods (n = 4910).

Figure 2

Percentage of patients diagnosed with kidney disease who were elderly (≥60 years-old), from 2008 to 2017.

Figure 3

Pathological types of PGN during different periods. ^∗p < 0.05, ^∗∗p < 0.01, and ^∗∗∗p < 0.001 by the chi-square test. Abbreviations: IgAN: IgA nephropathy; MN: membranous nephropathy; MsPGN: mesangial proliferative glomerulonephritis; MCD: minimal change disease; GML: glomerular minor lesion; FSGS: focal segmental glomerulosclerosis; MPGN: membranoproliferative glomerulonephritis; EnPGN: endocapillary proliferative glomerulonephritis; CreGN: crescentic glomerulonephritis; others: proliferative sclerosis and sclerosing glomerulonephritis.

Figure 4

Changes in the percentages of PGN cases with MN and IgAN, from 2008 to 2017.

Figure 5

Pathological types of SGN during different periods. ^∗p < 0.05, ^∗∗p < 0.01, and ^∗∗∗p < 0.001 by the chi-square test. Abbreviations. LN: lupus nephritis; HSPN: Henoch-Schönlein purpura nephritis; DN: diabetic nephropathy; HT/MHTARD: hypertension/malignant hypertension-associated renal damage; HBV-GN: hepatitis B virus associated nephritis; SVARD: systemic vasculitis-associated renal damage; AN: amyloidosis nephropathy; OAG: obesity-associated glomerulopathy; LCDD: light chain deposition nephropathy; IN: ischemic nephropathy; others: SSARD: Sjogren's syndrome associated renal damage; MCTARD: mixed connective tissue disease associated renal damage; HUS: hemolysis aemolytic uraemic syndrome; C3GN: C3 glomerulopathy; LPN: lipoprotein glomerulopathy; CUAN: chronic uric acid nephropathy; ING: idiopathic nodular glomerulosclerosis.