Sarwal Dhruv, D'Cruz Sanjay, Singh Punia Raj Pal, Minz Ranjana Walker
Department of Medicine, Government Medical College, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Department of Pathology, Government Medical College, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Saudi J Kidney Dis Transpl. 2019 Mar-Apr;30(2):492-500. doi: 10.4103/1319-2442.256856.
We analyzed the spectrum of biopsy-proven renal disease in a single tertiary care center in North India from 2007 to 2016. A total of 420 biopsies were analyzed. Patients were excluded if clinical details were unavailable or if either the histopathology core or the IF core was inadequate. In the final analysis, 359 biopsies were included. All clinical, laboratory, histopathological, and immunofluorescence (IF) findings were recorded in each case. The usefulness of IF in reaching a definitive diagnosis was also analyzed. The patients were in the age range of 2-94 years; 23.1% were children and 76.9% were adults. Males (60.4%) outnumbered females (39.6%) in all the disease categories except lupus nephritis (LN). Primary glomerular diseases (PGDs) (n = 297, 82.7%) were more common than secondary glomerular diseases (SGDs) (n = 46, 12.8%) and tubulointerstitial diseases (n = 16, 4.5%). The most common PGD was focal segmental glomerulosclerosis (FSGS) (23.4%), followed by minimal change disease (17%) and membranous nephropathy (12.5%), whereas the most common SGD was LN, seen in 9.2%. In the present study, IF helped in reaching the final diagnosis in 44.3%. The entities in which IF was most useful in reaching the final diagnoses were FSGS (31.5%) and IgA nephropathy (14.5%). The final pathological diagnosis correlated with the first clinical possibility in 207 of 359 (57.7%) cases. This 10-year study provides descriptive data and highlights the changing pattern of renal disease possibly due to an increased awareness and referral to higher centers.
我们分析了2007年至2016年印度北部一家三级医疗中心经活检证实的肾脏疾病谱。共分析了420份活检样本。若临床细节缺失或组织病理学核心样本或免疫荧光(IF)核心样本不足,则将患者排除。最终分析纳入了359份活检样本。记录了每例患者的所有临床、实验室、组织病理学和免疫荧光(IF)检查结果。还分析了IF在明确诊断中的作用。患者年龄在2至94岁之间;23.1%为儿童,76.9%为成人。除狼疮性肾炎(LN)外,所有疾病类别中男性(60.4%)均多于女性(39.6%)。原发性肾小球疾病(PGD)(n = 297,82.7%)比继发性肾小球疾病(SGD)(n = 46,12.8%)和肾小管间质疾病(n = 16,4.5%)更常见。最常见的PGD是局灶节段性肾小球硬化(FSGS)(23.4%),其次是微小病变病(17%)和膜性肾病(12.5%),而最常见的SGD是LN,占9.2%。在本研究中,IF有助于最终诊断的比例为44.3%。IF在最终诊断中最有用的疾病实体是FSGS(31.5%)和IgA肾病(14.5%)。359例中有207例(57.7%)最终病理诊断与最初临床可能性相符。这项为期10年的研究提供了描述性数据,并突出了肾脏疾病模式的变化,这可能是由于意识提高以及转诊至上级中心所致。