Soyibo A K, Shah D, Barton E N, Williams W, Smith R
Caribbean Institute of Nephrology, Department of Medicine, The University of the West Indies, Kingston 7, Jamaica, West Indies.
West Indian Med J. 2009 Jun;58(3):265-9.
In 2006, it was reported that Focal and Segmental Glomerulosclerosis (FSGS), Minimal Change Disease (MCD) and Membranous Glomerulonephritis (MGN) were the commonest primary glomerular diseases identified from percutaneous kidney biopsies done in Jamaica for that year (n = 76). The sample size was thought to be small and might have affected the reported findings. So a three-year review of percutaneous kidney biopsies in Jamaica was carried out.
Histology reports and clinical data were reviewed for percutaneous kidney biopsies performed from January 2005 to December 2007. Demographic data (age, gender), laboratory investigations such as serum urea, serum creatinine, proteinuria, haematuria, 24-hour urinary protein, and creatinine clearance, and clinical diagnosis were collected from the histology requisition form.
There was a total of 224 native kidney biopsies performed. There were 91 males (40.6%) and 133females (59.4%). Age distribution showed a total number of 25 paediatric cases (11.2%) and 199 adult cases (88.8%). Proteinuria was present in 171 cases (76.3%) and haematuria in 86 cases (38.4%). Of the total biopsies done, 78 cases (39.2%) had primary glomerular diseases, 110 cases (55.3%) had secondary glomerular diseases and 11 (5.5%) biopsies were reported as either normal or inadequate for histological diagnosis. The most common reasons indicated for percutaneous kidney biopsy were proteinuria, haematuria and staging of lupus nephritis. Most common histological findings for primary glomerular disease after percutaneous kidney biopsy were FSGS (n = 34), MGN (n = 15) and MCD (n = 12). In secondary glomerular diseases (n = 110), there were more females (70.8%) than males. Systemic lupus erythematosus was present in 63.3%. Histology of lupus nephritis according to the International Society of Nephrologists classification shows Membranous Lupus Nephritis [MLN] (40.20%), Diffuse Lupus Nephritis [DLN] (19.5%) and Minimal Mesangial Lupus Nephritis [MMLN] (14.3%) as the common histological types.
The most common histological finding for primary glomerular disease following percutaneous kidney biopsy was FSGS, MCD and MGN. Membranous Lupus Nephritis was the commonest histological type for lupus nephritis in this series.
2006年有报告称，局灶节段性肾小球硬化（FSGS）、微小病变性肾病（MCD）和膜性肾小球肾炎（MGN）是当年在牙买加进行的经皮肾活检中确诊的最常见的原发性肾小球疾病（n = 76）。当时认为样本量较小，可能影响了报告结果。因此，对牙买加三年间的经皮肾活检进行了回顾性研究。
回顾了2005年1月至2007年12月期间经皮肾活检的组织学报告和临床资料。从组织学申请单中收集人口统计学数据（年龄、性别）、实验室检查结果，如血清尿素、血清肌酐、蛋白尿、血尿、24小时尿蛋白及肌酐清除率，以及临床诊断。
共进行了224例自体肾活检。其中男性91例（40.6%），女性133例（59.4%）。年龄分布显示，儿科病例共25例（11.2%），成人病例199例（88.8%）。171例（76.3%）存在蛋白尿，86例（38.4%）存在血尿。在所有活检病例中，78例（39.2%）患有原发性肾小球疾病，110例（55.3%）患有继发性肾小球疾病，11例（5.5%）活检报告为正常或组织学诊断不充分。经皮肾活检最常见的指征是蛋白尿、血尿和狼疮性肾炎分期。经皮肾活检后原发性肾小球疾病最常见的组织学表现为FSGS（n = 34）、MGN（n = 15）和MCD（n = 12）。在继发性肾小球疾病（n = 110）中，女性（70.8%）多于男性。系统性红斑狼疮占63.3%。根据国际肾脏病学会分类，狼疮性肾炎的组织学表现以膜性狼疮性肾炎[MLN]（40.20%）、弥漫性狼疮性肾炎[DLN]（19.5%）和轻微系膜增生性狼疮性肾炎[MMLN]（14.3%）最为常见。
经皮肾活检后原发性肾小球疾病最常见的组织学表现为FSGS、MCD和MGN。在本研究系列中，膜性狼疮性肾炎是狼疮性肾炎最常见的组织学类型。
