Carvalho Elisio, do Sameiro Faria Maria, Nunes José Pedro L, Sampaio Susana, Valbuena Carmen
Department of Nephrology, Hospital Sao Joao, Faculty of Medicine, University of Porto, Portugal.
J Nephrol. 2006 Jul-Aug;19(4):500-7.
Data from registries of renal biopsy (RB), currently an important source for diagnosing renal disease, are available for a number of countries, but different patterns seem to exist in different countries.
We reviewed the records of all patients who underwent an RB at our institution over a 27-year period (January 1, 1977, to December 31, 2003), in northern Portugal, a European region with a predominantly Caucasian population. We aimed at identifying patterns of glomerular disease frequency, as well as the corresponding changes over time. The patients were grouped for analysis in 9-year intervals: period A (1977 through 1985), period B (1986 through 1994) and period C (1995 through 2003).
Nephrotic syndrome was the most common clinical presentation for RB (42.0%), followed by urinary abnormalities (28.5%), acute renal failure (9.7%), chronic renal failure (9.3%) and nephritic syndrome (9.3%). Primary glomerulonephritis (GN) was the most common type of kidney disease in the present study, representing 50.4% of all renal pathology, followed by secondary GN (29.4%) and vascular and tubulointerstitial diseases (14.0%). The relative frequency of secondary GN and vascular and tubulointerstitial diseases increased significantly over time, and so did IgA nephropathy, the most common type of primary glomerular disease in the present study (31.2%). Focal and segmental glomerulosclerosis represented 6.9% of primary glomerular disease, and its frequency did not increase in the time period under study. Regarding secondary glomerular diseases, apparent changes were noted in the incidence of a number of diseases, including vasculitis, thin glomerular basement membrane disease and Henoch-Schönlein pur-pura. A somewhat similar situation was noted with vascular and tubulointerstitial diseases.
We conclude that, as occurs in other European and Asiatic populations, and unlike the findings in the American continent, IgA nephropathy is the most frequent glomerular disease in our population.
肾活检（RB）登记数据目前是诊断肾脏疾病的重要来源，许多国家都有相关数据，但不同国家似乎存在不同模式。
我们回顾了1977年1月1日至2003年12月31日这27年间在我们机构接受RB的所有患者的记录，该机构位于葡萄牙北部，是一个以白种人为主的欧洲地区。我们旨在确定肾小球疾病的频率模式以及随时间的相应变化。患者按9年间隔分组进行分析：A期（1977年至1985年）、B期（1986年至1994年）和C期（1995年至2003年）。
肾病综合征是RB最常见的临床表现（42.0%），其次是尿液异常（28.5%）、急性肾衰竭（9.7%）、慢性肾衰竭（9.3%）和肾炎综合征（9.3%）。原发性肾小球肾炎（GN）是本研究中最常见的肾脏疾病类型，占所有肾脏病理的50.4%，其次是继发性GN（29.4%）以及血管和肾小管间质疾病（14.0%）。继发性GN以及血管和肾小管间质疾病的相对频率随时间显著增加，本研究中最常见的原发性肾小球疾病IgA肾病也是如此（31.2%）。局灶节段性肾小球硬化占原发性肾小球疾病的6.9%，其频率在研究时间段内未增加。关于继发性肾小球疾病，在一些疾病的发病率方面出现了明显变化，包括血管炎、薄肾小球基底膜病和过敏性紫癜。血管和肾小管间质疾病也出现了类似情况。
我们得出结论，与其他欧洲和亚洲人群一样，与美洲大陆的研究结果不同，IgA肾病是我们人群中最常见的肾小球疾病。
