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[以色列北部地区基于肾活检的肾脏疾病——海法市巴伊兰大学附属齐翁医学中心14年经验]

[KIDNEY DISEASES IN NORTH ISRAEL ACCORDING TO KIDNEY BIOPSIES - BNAI-ZION MEDICAL CENTER 14 YEARS' EXPERIENCE].

作者信息

Storch Shimon, Willner Nadav, Toubi Aurora, Croitoru Simona, Wolfson Vladimir, Matar Ibrahim, Grushka Elinor, Odeh Majed, Wolfovits Efrat, Schiff Elad, Rosner Yitzhak, Toubi Elias, Kessel Aharon, Ben Izhak Ofer, Moskovitz Boaz, Nativ Ofer

机构信息

Nephrology and Hypertension Unit, Bnai-Zion Medical Center, Haifa.

Department of Internal Medicine B, Bnai-Zion Medical Center, Haifa.

出版信息

Harefuah. 2016 Sep;155(9):537-541.

Abstract

INTRODUCTION

Little is known about the prevalence of kidney diseases according to renal biopsy in Israel. Since updated literature worldwide emphasizes changing etiologies of chronic kidney disease, it is crucial to research and define the epidemiology and pathology of kidney disease in Israel. Hereby, we introduce an original review of the prevalence of kidney diseases in our study population, which we believe reflects the prevalence of kidney diseases in the population of Israel.

AIMS

To investigate the prevalence of kidney diseases diagnosed by renal biopsy, according to age, gender, race and clinical symptoms.

METHODS

A total of 155 kidney biopsies were conducted in the years 2000-2014 in Bnai-Zion Medical Center in Haifa, according to formal accepted indications. Most of the biopsies (65%) were needle aspirations in a retroperitoneal approach, in which 90% were ultrasound guided and the rest computed tomography guided, while the other 35% of biopsies involved laparoscopic approaches.

RESULTS

The most common indications for kidney biopsy were nephrotic syndrome, nephritic syndrome and proteinuria (37.4%, 25.8% and 24.5%, respectively). Average glomeruli number per biopsy was 17.5 vs. 82.2 for needle aspiration and laparoscopic approach, respectively (statistically significant). The most common diagnosis was focal segmental glomerulosclerosis (FSGS), followed by chronic glomerulonephritis, IgA nephropathy, lupus nephritis, minimal change disease (MCD), membranous nephropathy and tubulointerstitial disease (20%, 11.5%, 11.5%, 10.1%, 9.5%, 8.1% and 6.1%, respectively).

CONCLUSIONS

FSGS was the most common diagnosis in patients presented with nephrotic syndrome or proteinuria, men, and patients above 60 years of age. Patients below 30 years of age were mainly diagnosed with IgA nephropathy.

DISCUSSION

In recent years, FSGS is becoming more prevalent compared with other chronic kidney disease especially in the older population. IgA nephropathy is still the most common diagnosis in young patients and in patients presented with hematuria. To the best of our knowledge, no data exists on the prevalence of kidney diseases in Israel, and our study is an important contribution to the epidemiological and clinical knowledge on the subject.

摘要

引言

以色列通过肾活检得出的肾脏疾病患病率鲜为人知。鉴于全球最新文献强调慢性肾脏病病因的变化,研究并明确以色列肾脏疾病的流行病学和病理学至关重要。在此,我们对研究人群中肾脏疾病的患病率进行了原创性综述,我们认为该综述反映了以色列人群中肾脏疾病的患病率。

目的

根据年龄、性别、种族和临床症状,调查经肾活检诊断的肾脏疾病的患病率。

方法

2000年至2014年期间,在海法的贝纳伊锡安医疗中心按照正式认可的指征共进行了155例肾活检。大多数活检(65%)采用经腹膜后途径的针吸活检,其中90%在超声引导下进行,其余在计算机断层扫描引导下进行,另外35%的活检采用腹腔镜途径。

结果

肾活检最常见的指征是肾病综合征、肾炎综合征和蛋白尿(分别为37.4%、25.8%和24.5%)。每次活检的平均肾小球数量针吸活检为17.5个,腹腔镜途径为82.2个(具有统计学意义)。最常见的诊断是局灶节段性肾小球硬化(FSGS),其次是慢性肾小球肾炎、IgA肾病、狼疮性肾炎、微小病变病(MCD)、膜性肾病和肾小管间质性疾病(分别为20%、11.5%、11.5%、10.1%、9.5%、8.1%和6.1%)。

结论

FSGS是肾病综合征或蛋白尿患者、男性以及60岁以上患者中最常见的诊断。30岁以下患者主要诊断为IgA肾病。

讨论

近年来,与其他慢性肾脏病相比,FSGS在老年人群中更为普遍。IgA肾病仍是年轻患者和血尿患者中最常见的诊断。据我们所知,以色列尚无肾脏疾病患病率的数据,我们的研究对该主题的流行病学和临床知识做出了重要贡献。

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