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印度的儿科肾活检:六年单中心经验

Pediatric Renal Biopsies in India: A Single-Centre Experience of Six Years.

作者信息

Kanodia Kamal V, Vanikar Aruna V, Nigam Lovelesh K, Patel Rashmi D, Suthar Kamlesh S, Gera Dinesh N, Trivedi Hargovind L

机构信息

Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences, Asarwa, India.

Department of Nephrology and Transplantation Medicine and Director, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences, Asarwa, India.

出版信息

Nephrourol Mon. 2015 Jun 28;7(4):e25473. doi: 10.5812/numonthly.25473. eCollection 2015 Jul.

Abstract

BACKGROUND

Renal biopsy is a well-established diagnostic modality for the assessment of kidney diseases in children. It can provide diagnostic precision and prognostic value and guide in therapeutic options for many renal diseases.

OBJECTIVES

This report describes the indication, histopathological patterns, and epidemiology of renal diseases in children in India.

PATIENTS AND METHODS

This is a single-center study on renal biopsies performed between January 2008 and December 2013 in 346 children (age ≤ 14 years).

RESULTS

Eleven (3.17%) biopsies were inadequate, and 335 biopsies were considered for analysis. The mean age was 7.91 ± 3.04 years with a predominance of males (68.1%). Nephrotic syndrome (46.2%) was the most common indication, followed by urinary abnormality (41.19%), acute nephritic syndrome (10.74%), and chronic renal failure (1.79 %). Primary glomerulonephritis (GN) was predominant (81.79%), and secondary GN constituted 16.12% of the biopsies. Primary GN included mesangial proliferative GN (MePGN), IgM nephropathy, focal segmental glomerulosclerosis, minimal change disease, IgA nephropathy, membranoproliferative GN, membranous nephropathy, crescentic GN, and post-infectious GN. Secondary GN revealed lupus nephritis, hemolytic uremic syndrome, amyloidosis, and hypertensive nephropathy. Tubulointerstitial nephritis was observed in 2.08%. The most common histological pattern of primary GN was MePGN (20%) and in secondary GN it was lupus nephritis (7.76%).

CONCLUSIONS

The present study provides data on the epidemiology of renal diseases in children in India and will be helpful for developing a national registry and devising therapeutic guidelines.

摘要

背景

肾活检是评估儿童肾脏疾病的一种成熟的诊断方法。它可以提供诊断准确性和预后价值,并为许多肾脏疾病的治疗选择提供指导。

目的

本报告描述了印度儿童肾脏疾病的适应症、组织病理学模式和流行病学。

患者和方法

这是一项对2008年1月至2013年12月期间在346名儿童(年龄≤14岁)中进行的肾活检的单中心研究。

结果

11例(3.17%)活检标本不合格,335例活检标本用于分析。平均年龄为7.91±3.04岁,男性占优势(68.1%)。肾病综合征(46.2%)是最常见的适应症,其次是尿液异常(41.19%)、急性肾炎综合征(10.74%)和慢性肾衰竭(1.79%)。原发性肾小球肾炎(GN)占主导地位(81.79%),继发性GN占活检标本的16.12%。原发性GN包括系膜增生性GN(MePGN)、IgM肾病、局灶节段性肾小球硬化、微小病变病、IgA肾病、膜增生性GN、膜性肾病、新月体性GN和感染后GN。继发性GN包括狼疮性肾炎、溶血尿毒综合征、淀粉样变性和高血压肾病。观察到肾小管间质性肾炎占2.08%。原发性GN最常见的组织学模式是MePGN(20%),继发性GN中最常见的是狼疮性肾炎(7.76%)。

结论

本研究提供了印度儿童肾脏疾病的流行病学数据,将有助于建立国家登记系统并制定治疗指南。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b7d/4623712/f23ed914c381/num-07-04-25473-i001.jpg

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