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塞尔维亚某单一中心 10 年回顾:儿童肾活检的适应证和结果。

Indications and results of renal biopsy in children: a 10-year review from a single center in Serbia.

机构信息

Department of Nephrology, University Children's Hospital, Belgrade, Serbia.

出版信息

J Nephrol. 2012 Nov-Dec;25(6):1054-9. doi: 10.5301/jn.5000095.

Abstract

BACKGROUND

This study was conducted to retrospectively investigate the indications for renal biopsy in native kidneys and to analyze pathological findings in the last 10 years in a single tertiary pediatric hospital in Serbia.

METHODS

All patients who underwent renal biopsy at our hospital between 2001 and 2010 were included in the present study. Renal biopsy was performed under fluoroscopy with a biopsy gun. All renal biopsies were studied under light and immunofluorescent microscopy, while electron microscopy was rarely performed.

RESULTS

The study group included 150 patients (56% female) who underwent 158 percutaneous native kidney biopsies. Median age was 11.5 years (range 0.2-20 years). The most frequent indications for renal biopsy were nephrotic syndrome (32.9%), asymptomatic hematuria (23.4%), urinary abnormalities in systemic diseases (15.8%) and proteinuria (11.4%). Primary glomerulonephritis (GN) was the most common finding (57.4%), followed by secondary GN (15.5%) and tubulointerstitial diseases (4.5%). According to histopathological diagnosis, the most common causes of primary GN were focal segmental glomerulosclerosis (20.9%), mesangioproliferative GN (14.6%), IgA nephropathy (8.9%) and minimal change disease (13%). Lupus nephritis (6%) and Henoch-Schönlein nephritis (4%) were the most common secondary glomerular diseases.

CONCLUSIONS

The epidemiology of glomerular disease in our single-center report is similar to that in data from adjacent Croatia and Greece. Focal segmental glomerulosclerosis was the dominant histopathological finding, followed by mesangioproliferative GN and IgA nephropathy.

摘要

背景

本研究旨在回顾性调查塞尔维亚一家三级儿科医院的原发性肾脏活检适应证,并分析过去 10 年的病理发现。

方法

本研究纳入了 2001 年至 2010 年在我院行肾活检的所有患者。肾活检在透视下使用活检枪进行。所有肾活检均行光镜和免疫荧光显微镜检查,很少行电镜检查。

结果

研究组包括 150 例(56%为女性)患者,共进行了 158 例经皮原发性肾脏活检。中位年龄为 11.5 岁(范围 0.2-20 岁)。肾活检的最常见适应证为肾病综合征(32.9%)、无症状性血尿(23.4%)、系统性疾病中的尿液异常(15.8%)和蛋白尿(11.4%)。原发性肾小球肾炎(GN)是最常见的发现(57.4%),其次是继发性 GN(15.5%)和肾小管间质疾病(4.5%)。根据组织病理学诊断,原发性 GN 最常见的病因是局灶节段性肾小球硬化症(20.9%)、系膜增生性 GN(14.6%)、IgA 肾病(8.9%)和微小病变性肾病(13%)。狼疮肾炎(6%)和过敏性紫癜性肾炎(4%)是最常见的继发性肾小球疾病。

结论

我们的单中心报告中的肾小球疾病流行病学与来自相邻克罗地亚和希腊的数据相似。局灶节段性肾小球硬化症是主要的组织病理学发现,其次是系膜增生性 GN 和 IgA 肾病。

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