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经活检证实的继发性肾小球疾病谱:中国的一项横断面研究

The spectrum of biopsy-proven secondary glomerular diseases: A cross-sectional study in China
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作者信息

Wang Ping, Tang Lijun, Yao Jing, Su Hong, Liu Yipeng, Kong Xianglei, Li Wenbin, Cui Meiyu, Sun Qing, Zhen Junhui, Xu Dongmei

出版信息

Clin Nephrol. 2017 Nov;88(11):270-276. doi: 10.5414/CN109115.

Abstract

AIMS

The distribution of the spectrum of chronic kidney disease (CKD) has been found to vary with time. Limited information is available regarding the changing spectrum of secondary glomerular diseases (SGDs). To further investigate changes in the spectrum of SGDs, we performed a cross-sectional study.

METHODS

From June 2010 to May 2015, 5,935 patients from 37 hospitals in Shandong Province were involved in this study. The study was divided into five periods according to 1-year intervals. The patients were divided into four age groups.

RESULTS

Of the 5,935 patients with qualified specimens, 1,038 (17.5%) were diagnosed with a SGD. Lupus nephritis (LN) (27.6%) was the most frequently identified SGD, followed by Henoch-Schönlein purpura glomerulonephritis (HSPN) (21.7%) and diabetic nephropathy (DN) (21.6%). The prevalence rate of DN demonstrated an increasing trend, and this condition became the leading cause of renal biopsy in period 3 (29.3%). The proportion of patients with hepatitis B virus-associated nephritis (HBVAN) decreased from 14.7% in period 2 to 5.1% in period 5 (p < 0.001). The proportion of patients with amyloidosis nephropathy (AN) increased from 2.2% in period 1 to 7.0% in period 5 (p = 0.088). The prevalence rate of DN was 0.6% in pediatric patients and 40.7% in elderly patients (p < 0.001).

CONCLUSIONS: In our study, SGD was the second leading cause of renal biopsy. The distribution of the spectrum of SGD varied with time and age. Given the possibility of a detection bias, larger prospective cohort studies are needed in the future.
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摘要

目的

已发现慢性肾脏病(CKD)的谱分布随时间变化。关于继发性肾小球疾病(SGD)谱变化的信息有限。为进一步研究SGD谱的变化,我们进行了一项横断面研究。

方法

2010年6月至2015年5月,来自山东省37家医院的5935例患者参与了本研究。该研究按1年间隔分为五个时期。患者分为四个年龄组。

结果

在5935例有合格标本的患者中,1038例(17.5%)被诊断为SGD。狼疮性肾炎(LN)(27.6%)是最常被确诊的SGD,其次是过敏性紫癜性肾小球肾炎(HSPN)(21.7%)和糖尿病肾病(DN)(21.6%)。DN的患病率呈上升趋势,在第3期成为肾活检的主要原因(29.3%)。乙型肝炎病毒相关性肾炎(HBVAN)患者的比例从第2期的14.7%降至第5期的5.1%(P<0.001)。淀粉样变性肾病(AN)患者的比例从第1期的2.2%增至第5期的7.0%(P=0.088)。DN在儿科患者中的患病率为0.6%,在老年患者中为40.7%(P<0.001)。

结论

在我们的研究中,SGD是肾活检的第二大主要原因。SGD谱的分布随时间和年龄而变化。鉴于存在检测偏倚的可能性,未来需要开展更大规模的前瞻性队列研究。

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