Department of Pediatric Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
J Nephrol. 2009 Nov-Dec;22(6):739-46.
In the absence of a national pediatric renal biopsy registry, there is a paucity of information on the pattern of childhood renal disease observed in Pakistan. A few studies previously reported are based on light microscopic study of renal biopsies only. This is the first study from this country which is based on light, immunofluorescence and electron microscopic study of native renal biopsies.
We undertook a retrospective review of native renal biopsies performed in children who presented with signs and symptoms related to renal diseases at the Sindh Institute of Urology and Transplantation during the period of July 1995 to June 2008. The renal biopsy diagnoses were categorized into the following groups: primary glomerulopathies, secondary glomerulopathies, tubulointerstitial diseases, renal vascular diseases, hereditary diseases and unclassified.
Glomerulopathies were the commonest diagnosis, representing 93.34% of all biopsies. Primary glomerulopathies accounted for 87.64% and secondary glomerulopathies for 5.7%. When primary glomerulopathies were further analyzed, minimal change disease was the leading histopathological pattern, found in 29.4% of all biopsies, followed by focal segmental glomerulosclerosis, seen in 21.8% of cases. Among secondary glomerulopathies, lupus nephritis was the commonest, followed by amyloidosis and hemolytic uremic syndrome. Tubulointerstitial and vascular diseases were rare, representing 2.8% and 0.8% of all biopsy diagnoses, respectively.
Our pattern of biopsied pediatric renal pathology is similar to that reported recently in series with similar biopsy indications from other parts of the world.
由于缺乏全国性的儿科肾活检登记，关于巴基斯坦儿童肾脏病的观察模式，相关信息非常有限。以前的一些研究仅基于肾活检的光镜检查。这是来自该国的第一项基于光镜、免疫荧光和电子显微镜检查对原发性肾活检进行研究的报告。
我们对 1995 年 7 月至 2008 年 6 月期间在信德省泌尿外科学和移植研究所就诊的伴有肾脏疾病相关症状和体征的儿童进行了回顾性分析。将肾活检诊断分为以下几类：原发性肾小球疾病、继发性肾小球疾病、肾小管间质疾病、肾血管疾病、遗传性疾病和未分类。
肾小球疾病是最常见的诊断，占所有活检的 93.34%。原发性肾小球疾病占 87.64%，继发性肾小球疾病占 5.7%。当进一步分析原发性肾小球疾病时，微小病变性疾病是最主要的组织病理学表现，在所有活检中占 29.4%，其次是局灶节段性肾小球硬化症，占 21.8%。在继发性肾小球疾病中，狼疮性肾炎最常见，其次是淀粉样变性和溶血尿毒综合征。肾小管间质和血管疾病罕见，分别占所有活检诊断的 2.8%和 0.8%。
我们的小儿肾活检病理学模式与最近在具有类似活检指征的来自世界其他地区的系列研究中报告的模式相似。
