Department of Nephrology, Christian Medical College and Hospital, Vellore, India.
Academic Research Department, Narayana Hrudayalaya Foundations, Bangalore, India.
Nephrology (Carlton). 2018 Nov;23(11):1013-1022. doi: 10.1111/nep.13160.
We report findings from a large single centre paediatric renal biopsy cohort in South Asia.
We analyzed all renal biopsies performed on children aged ≤18 years between 1996 and 2015 at our centre. The clinical characteristics and histological diagnosis pertaining to each case, distribution of renal diseases in children with various clinical presentations, and changes in the pattern of kidney disease during the study period were analyzed.
A total of 1740 paediatric kidney biopsies were performed during the study period. The mean age was 12.8 ± 4.9 years (8 months to 18 years) and the male: female ratio was 1.5:1. The most common indication for renal biopsy was nephrotic syndrome (63.2%) followed by acute nephritic syndrome (13%). Minimal change disease was the most common cause of nephrotic syndrome while endocapillary proliferative glomerulonephritis (65.7% infection related), remained the commonest cause of acute nephritic syndrome. IgA nephropathy was the commonest cause of chronic kidney disease. Contrary to trends in European paediatric cohorts, the frequency of lupus nephritis increased over the two decades of the study, while that of endocapillary proliferative glomerulonephritis did not show any appreciable decline.
This study provides the largest data on biopsy proven renal disease in children from South Asia published till date and highlights important differences in the spectrum and trends of kidney disease compared to data from other regions.
我们报告了南亚一个大型单中心儿科肾脏活检队列的研究结果。
我们分析了 1996 年至 2015 年期间在我们中心进行的所有≤18 岁儿童的肾脏活检。分析了每个病例的临床特征和组织学诊断、不同临床表现儿童的肾脏疾病分布以及研究期间肾脏疾病模式的变化。
在研究期间共进行了 1740 例儿科肾脏活检。平均年龄为 12.8±4.9 岁（8 个月至 18 岁），男女比例为 1.5:1。肾脏活检的最常见指征是肾病综合征（63.2%），其次是急性肾炎综合征（13%）。微小病变性肾病是肾病综合征最常见的病因，而毛细血管内增生性肾小球肾炎（65.7%与感染有关）仍然是急性肾炎综合征最常见的病因。IgA 肾病是慢性肾脏病的常见病因。与欧洲儿科队列的趋势相反，狼疮肾炎的频率在研究的二十年中增加了，而毛细血管内增生性肾小球肾炎的频率并没有明显下降。
本研究提供了迄今为止南亚地区经活检证实的儿童肾脏疾病的最大数据，并强调了与其他地区相比，肾脏疾病的谱和趋势存在重要差异。
