Division of Nephrology at Lenox Hill Hospital, Long Island Jewish Medical, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
Department of Pathology at Lenox Hill Hospital, Long Island Jewish Medical, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA.
Int Urol Nephrol. 2021 Apr;53(4):719-724. doi: 10.1007/s11255-020-02658-w. Epub 2020 Nov 17.
There have been conflicting data on the relative frequency of common forms of primary nephrotic syndrome (PNS). We undertook this study to look at the causes of PNS in the latest decade from our biopsy population, with a special attention to breakdown by race.
Retrospective chart review of all cases of adult PNS extracted from a database of 1388 cases for the last 10 years. We were careful to exclude patients with secondary disease and without the full nephrotic syndrome.
There were 115 cases of PNS. Overall, MN was the most common lesion (40.0%), followed by minimal change disease (MCD) (34.0%), focal segmental glomerulosclerosis (FSGS) (13.0%), and IgA nephropathy (IgAN) (11.3%). Among whites, MN was the most common cause of NS (41.7%), followed by MCD (33.3%), IgAN (16.7%), and FSGS (6.3%). Among blacks, FSGS was the most common lesion (33.3%) followed closely by MN (29.6%), and MCD (26.0%). IgAN was present in 7.4%. Among multiracial patients (MR), MGN was the most common (50%) followed by MCD (45.5%) and FSGS (4.5%). In Asians, MCD (50.1%) and MGN (33.3%) were the most common, followed by FSGS and IgAN with 8.3% each.
MN and MCD were the most common causes of PNS in our population, with FSGS much less common overall. This is especially the case among whites and MR. Among blacks, MN and FSGS were almost codominant causes. The apparent decreased prevalence of FSGS may be related to more effective exclusion of secondary and maladaptive causes.
原发性肾病综合征（PNS）的常见类型的相对频率存在相互矛盾的数据。我们进行这项研究，旨在观察过去十年中我们的活检人群中 PNS 的病因，特别关注按种族分类的情况。
对过去十年中从 1388 例患者数据库中提取的所有成人 PNS 病例进行回顾性图表审查。我们非常注意排除患有继发性疾病且未完全出现肾病综合征的患者。
共有 115 例 PNS 患者。总体而言，膜性肾病（MN）是最常见的病变（40.0%），其次是微小病变性肾病（MCD）（34.0%）、局灶节段性肾小球硬化症（FSGS）（13.0%）和 IgA 肾病（IgAN）（11.3%）。在白人中，MN 是 NS 的最常见病因（41.7%），其次是 MCD（33.3%）、IgAN（16.7%）和 FSGS（6.3%）。在黑人中，FSGS 是最常见的病变（33.3%），紧随其后的是 MN（29.6%）和 MCD（26.0%）。IgAN 占 7.4%。在多种族患者（MR）中，膜性肾小球肾炎（MGN）最常见（50%），其次是 MCD（45.5%）和 FSGS（4.5%）。在亚洲人中，MCD（50.1%）和 MGN（33.3%）最常见，其次是 FSGS 和 IgAN，各占 8.3%。
MN 和 MCD 是我们人群中 PNS 的最常见病因，FSGS 总体上要少见得多。这在白人和 MR 中尤其如此。在黑人中，MN 和 FSGS 几乎是同等的病因。FSGS 患病率的明显下降可能与更有效地排除继发性和适应性不良的病因有关。
