Imtiaz Salman, Drohlia Murtaza F, Nasir Kiran, Salman Beena, Ahmad Aasim
Department of Nephrology, Dorab Patel Post Graduate Training and Research Center, The Kidney Center Post Graduate Training Institute, Karachi, Pakistan.
Department of Biostatistics and Research, Dow University of Health Sciences, Karachi, Pakistan.
Saudi J Kidney Dis Transpl. 2017 Mar-Apr;28(2):368-378. doi: 10.4103/1319-2442.202788.
Renal biopsy is crucial while evaluating for the diagnosis of glomerular, vascular, tubulointerstitial, and genetic diseases. It gives vital information which helps in estimating the disease prognosis, progression, and management. This is the retrospective analysis of all adult patients aged above 18 years, who underwent percutaneous renal biopsy at The Kidney Center Post Graduate Training Institute, Karachi, over a duration of 18 years, i.e., January 1, 1996, to December 2013. Renal graft biopsies and those which were inadequate were excluded from analysis. Of the1962 biopsies performed, we included 1521 biopsies in our assessment. The mean age of the population was 38 ± 15.26 years (range 18-88 years). There were 920 (60.5%) males and 601 (39.5%) females. The most common clinical indication of kidney biopsy was nephrotic syndrome, i.e., 741 (45.7%), followed by chronic kidney disease, 253 (16.6%); acute renal failure, 184; (12.1%) and rapidly progressive glomerulonephritis (GN), 124 (8.2%). Primary GN was found in the majority of the patients, 984 (64.7%), followed by secondary GN in 249 (16.4%), tubulointerstitial disease in 224 (14.7%), and vascular disease in 64 (4.2%). In primary GN, focal segmental glomerulosclerosis was the most common histopathological diagnosis in 297 (19.5%) patients, followed by MGN in 224 (14.7%), chronic GN in 98 (6.4%), crescentic GN in 93 (6.1%), minimal change disease in 87 (5.7%), membranoproliferative glomerulonephritis in 58 (3.8%), and postinfection glomerulonephritis in 53 (3.5%) patients. This study shows that focal segmental glomerulosclerosis is the most common lesion in renal biopsy in the young age group followed by membranous nephropathy. Diabetic nephropathy and chronic interstitial nephritis were dominant secondary pathological lesions in older age group, whereas lupus nephritis was the most common secondary disease in young age females.
在评估肾小球、血管、肾小管间质和遗传性疾病的诊断时，肾活检至关重要。它能提供重要信息，有助于评估疾病的预后、进展及治疗。这是一项对所有18岁以上成年患者的回顾性分析，这些患者于1996年1月1日至2013年12月期间在卡拉奇肾脏中心研究生培训学院接受了经皮肾活检，为期18年。肾移植活检及不充分的活检被排除在分析之外。在进行的1962例活检中，我们纳入了1521例进行评估。研究人群的平均年龄为38±15.26岁（范围18 - 88岁）。男性920例（60.5%），女性601例（39.5%）。肾活检最常见的临床指征是肾病综合征，即741例（45.7%），其次是慢性肾脏病，253例（16.6%）；急性肾衰竭，184例（12.1%）；快速进展性肾小球肾炎（GN），124例（8.2%）。大多数患者为原发性GN，984例（64.7%），其次是继发性GN，249例（16.4%），肾小管间质疾病224例（14.7%），血管疾病64例（4.2%）。在原发性GN中，局灶节段性肾小球硬化是最常见的组织病理学诊断，297例（19.5%）患者，其次是膜性肾病，224例（14.7%），慢性GN 98例（6.4%），新月体性GN 93例（6.1%），微小病变病87例（5.7%），膜增生性肾小球肾炎58例（3.8%），感染后肾小球肾炎53例（3.5%）。本研究表明，局灶节段性肾小球硬化是年轻年龄组肾活检中最常见的病变，其次是膜性肾病。糖尿病肾病和慢性间质性肾炎是老年组主要的继发性病理病变，而狼疮性肾炎是年轻女性中最常见的继发性疾病。
