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儿童肾脏病的组织学模式:来自印度东北部一家三级医疗中心的 12 年经验。

Histological patterns of renal diseases in children: A 12-year experience from a single Tertiary Care Center in North-East India.

机构信息

Department of Nephrology, Gauhati Medical College and Hospital, Guwahati, Assam, India.

出版信息

Saudi J Kidney Dis Transpl. 2021 Mar-Apr;32(2):364-370. doi: 10.4103/1319-2442.335448.

Abstract

This study was conducted to retrospectively investigate the indications for renal biopsy in the native kidneys of children and to analyze the pathological findings in a single tertiary care hospital in North-East India for the past 12 years. All children (≤18 years) who underwent renal biopsy at our hospital from March 2007 to April 2018 were included. Renal tissue specimens were studied under light and immunofluorescence microscopy. The study group included 254 patients (female 57%). The median age was 15 years (range 6-18 years). The most frequent indications for renal biopsy were nephrotic syndrome (NS) (53.9%), urinary abnormality in systemic disease (22.1%), nephritic syndrome (15.4%), asymptomatic hematuria (4.7%), significant proteinuria (3.1%), and unexplained renal failure (0.8%). On histopathological examination, primary glomerular diseases were the most frequent (68.9%) followed by secondary glomerular diseases (30.3%) and tubulointerstitial diseases (0.8%). The most common primary glomerular diseases were minimal change disease (26.8%), focal segmental glomerular sclerosis (12.2%), diffuse proliferative glomerulonephritis (9.1%), membranous nephropathy (8.7%), IgA nephropathy (8.3%), membranoproliferative glomerulonephritis (2%), and mesangioproliferative glomerulonephritis (2%). Lupus nephritis (LN) (29.5%) was the most common secondary glomerular disease. NS was the most common indication of renal biopsy, and LN was the most common histopathological diagnosis in children ≤18 years.

摘要

本研究旨在回顾性调查儿童原发性肾脏活检的适应证,并分析印度东北部一家三级保健医院过去 12 年来的病理发现。本研究纳入了 2007 年 3 月至 2018 年 4 月期间在我院接受肾活检的所有儿童(≤18 岁)。对肾组织标本进行光镜和免疫荧光显微镜检查。研究组包括 254 例患者(女性 57%)。中位年龄为 15 岁(范围 6-18 岁)。肾脏活检的最常见适应证是肾病综合征(NS)(53.9%)、系统性疾病的尿液异常(22.1%)、肾炎综合征(15.4%)、无症状性血尿(4.7%)、大量蛋白尿(3.1%)和不明原因的肾衰竭(0.8%)。组织病理学检查显示,原发性肾小球疾病最常见(68.9%),其次是继发性肾小球疾病(30.3%)和肾小管间质疾病(0.8%)。最常见的原发性肾小球疾病是微小病变性肾病(26.8%)、局灶节段性肾小球硬化(12.2%)、弥漫性增生性肾小球肾炎(9.1%)、膜性肾病(8.7%)、IgA 肾病(8.3%)、膜增生性肾小球肾炎(2%)和系膜增生性肾小球肾炎(2%)。狼疮性肾炎(LN)(29.5%)是最常见的继发性肾小球疾病。NS 是肾脏活检最常见的适应证,LN 是儿童≤18 岁患者最常见的组织病理学诊断。

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