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肾小球疾病的临床病理研究:一项来自印度西北部的单中心、五年回顾性研究。

A clinicopathologic study of glomerular disease: A single-center, five-year retrospective study from Northwest India.

作者信息

Beniwal Pankaj, Pursnani Lalit, Sharma Sanjeev, Garsa R K, Mathur Mohit, Dharmendra Prasad, Malhotra Vinay, Agarwal Dhanajai

机构信息

Department of Nephrology, SMS Medical College and Hospital, Jaipur, Rajasthan, India.

出版信息

Saudi J Kidney Dis Transpl. 2016 Sep-Oct;27(5):997-1005. doi: 10.4103/1319-2442.190876.

Abstract

Studies published from centers across India have reported different and contradicting patterns of glomerular disease. In this retrospective study, we report our experience from a Tertiary Care Center in Northwest India. A total of 702 renal biopsies performed between 2008 and 2013 were reviewed of which 80 were excluded from the study because of having insufficient records or if the biopsies were taken from an allograft. The study included 411 males (66.1 %) and 211 females (33.9%) with an age range of 12-70 years (mean 30.34 ± 7.04 years). Majority of the biopsies (93.9%) showed some form of glomerulonephritis (GN), either primary (79.4%) or secondary glomerular disease (SGD) (14.5%). Minimal change disease (MCD) was the most common type of primary GN (26.5% of primary GN), followed by membranous nephropathy (MN; 18.8%) and focal and segmental glomerulosclerosis (FSGS; 13.2%). Lupus nephritis (LN) was the most frequent SGD (52.2% of secondary GN). Amyloidosis was found in 41.1% and diabetic glomerulosclerosis in 4.4%. LN was also the second most common diagnosis in females after MCD, seen in 19.4% of females. MCD followed by membranoproliferative GN and diffuse proliferative GN were the most common entities in individuals <20 years of age. In the 20-39 years age group, MN was the most common pathology seen. MN was again the most common pathology seen in patients aged above 40 years followed by amyloidosis and FSGS. In this study, MCD was the most common primary GN observed overall from this part of India. MN was the most common GN in individuals above 20 years of age presenting with the nephrotic syndrome. The geographical and regional differences in the pattern of GNs point to the necessity of having a central biopsy registry.

摘要

印度各地中心发表的研究报告了肾小球疾病不同且相互矛盾的模式。在这项回顾性研究中,我们报告了印度西北部一家三级医疗中心的经验。对2008年至2013年间进行的702例肾活检进行了回顾,其中80例因记录不充分或活检取自同种异体移植而被排除在研究之外。该研究包括411名男性(66.1%)和211名女性(33.9%),年龄范围为12至70岁(平均30.34±7.04岁)。大多数活检(93.9%)显示某种形式的肾小球肾炎(GN),原发性(79.4%)或继发性肾小球疾病(SGD)(14.5%)。微小病变病(MCD)是原发性GN最常见的类型(占原发性GN的26.5%),其次是膜性肾病(MN;18.8%)和局灶节段性肾小球硬化(FSGS;13.2%)。狼疮性肾炎(LN)是最常见的SGD(占继发性GN的52.2%)。淀粉样变性病占41.1%,糖尿病肾小球硬化占4.4%。LN也是女性继MCD之后的第二常见诊断,见于19.4%的女性。MCD其次是膜增生性GN和弥漫性增生性GN是<20岁个体中最常见的类型。在20至39岁年龄组中,MN是最常见的病理类型。MN再次是40岁以上患者中最常见的病理类型,其次是淀粉样变性病和FSGS。在这项研究中,MCD是印度这一地区总体上观察到的最常见的原发性GN。MN是20岁以上出现肾病综合征的个体中最常见的GN。GN模式的地理和区域差异表明有必要建立一个中央活检登记处。

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