Prema K S Jansi, Kurien Anila A, Gopalakrishnan Natarajan, Walker Patrick D, Larsen Christopher P
Renopath, Center for Renal and Urological Pathology, Chennai, India.
Department of Nephrology, Madras Medical College, Chennai, India.
Clin Kidney J. 2019 Jan 8;12(4):476-482. doi: 10.1093/ckj/sfy125. eCollection 2019 Aug.
We present the largest clinicopathologic case series to date of dense deposit disease (DDD) in an Indian population and compare the renal biopsy incidence rate to that seen in a large renal laboratory in USA.
Cases of DDD were identified and evaluated from native kidney biopsies reported at Renopath, India and at Arkana Laboratories, in the USA. Renopath receives biopsies from four states, located in the South and Eastern part of India. Arkana Laboratories' biopsies came from 37 states across the USA.
During the study period, there were a total of 25 patients diagnosed with DDD among the 7335 native kidney biopsies at Renopath. Thus, the biopsy incidence rate (cases of DDD/total renal biopsies/year) is 0.0034. By comparison, there were 10 cases of DDD diagnosed among 26 319 native kidney biopsies at Arkana Laboratories during the same time period, with a renal biopsy incidence rate of 0.00038.
DDD in this Indian subpopulation has similar clinical and pathologic characteristics when compared to previously reported studies. However, the biopsy incidence rate is about 890% or 8.9 times more common in this subset of the Indian population when compared with a broad cross-section of the US population. In addition to potential genetic factors, environmental conditions and chronic infections likely contribute to the markedly higher biopsy incidence rate. Given the much greater number of patients with DDD in this population, further retrospective and prospective studies would allow more rapid progress in understanding the pathogenesis of DDD and thus potential treatment of patients with DDD.
我们展示了迄今为止印度人群中致密物沉积病（DDD）最大的临床病理病例系列，并将肾活检发病率与美国一家大型肾脏实验室的发病率进行比较。
从印度的Renopath和美国的Arkana实验室报告的肾活检病例中识别并评估DDD病例。Renopath接收来自印度南部和东部四个邦的活检样本。Arkana实验室的活检样本来自美国37个州。
在研究期间，Renopath的7335例肾活检中有25例被诊断为DDD。因此，活检发病率（DDD病例数/每年肾活检总数）为0.0034。相比之下，同期Arkana实验室的26319例肾活检中有10例被诊断为DDD，肾活检发病率为0.00038。
与先前报道的研究相比，该印度亚人群中的DDD具有相似的临床和病理特征。然而，与美国广泛人群相比，该印度人群子集的活检发病率约高890%，即高8.9倍。除了潜在的遗传因素外，环境条件和慢性感染可能是活检发病率明显较高的原因。鉴于该人群中DDD患者数量更多，进一步的回顾性和前瞻性研究将有助于更快地了解DDD的发病机制，从而为DDD患者提供潜在的治疗方法。
