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肾活检中的肾小管毛细血管炎。

Peritubular Capillaritis in Native Kidney Biopsies.

机构信息

Department of Pathology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.

Department of Pathology, Eskisehir Osmangazi University, Eskisehir, Turkey.

出版信息

Am J Clin Pathol. 2022 Sep 2;158(3):389-394. doi: 10.1093/ajcp/aqac061.

Abstract

OBJECTIVES

To determine the frequency and predictors of peritubular capillaritis (PTCitis) among native kidney biopsies.

METHODS

Consecutive native kidney biopsies of 169 patients were reexamined for capturing possible PTCitis according to the Banff Classification. The relation of PTCitis with demographic and clinicopathologic findings was evaluated. Logistic regression analysis was performed to determine predictors of PTCitis.

RESULTS

Peritubular capillaritis was captured in 90 (53.3%) patients, with scores of 1, 2, and 3 in 57 (33.7%), 31 (18.3%), and 2 (1.2%) patients, respectively. The highest frequency of PTCitis was observed in pauci-immune glomerulonephritis. In univariate analysis, male sex, the presence of interstitial inflammation, pauci-immune glomerulonephritis, and a higher serum creatinine level were associated with a higher risk of PTCitis, while severe interstitial fibrosis/tubular atrophy was associated with a lower risk. The presence of interstitial inflammation (odds ratio [OR], 5.94 [95% confidence interval (CI), 1.41-25.03]; P = .015), pauci-immune glomerulonephritis (OR, 3.08 [95% CI, 1.01-9.36]; P = .048), and a higher serum creatinine level (per 1 mg/dL) (OR, 1.56 [95% CI, 1.14-2.11]; P = .005) were independent predictors of PTCitis development in a multivariate regression model.

CONCLUSIONS

Peritubular capillaritis is common in native biopsies and more likely to be observed in the presence of interstitial inflammation, pauci-immune glomerulonephritis, and a higher serum creatinine level.

摘要

目的

确定原发性肾脏活检中肾小管周围毛细血管炎(PTCitis)的频率和预测因素。

方法

根据 Banff 分类,对 169 例连续的原发性肾脏活检进行重新检查,以捕捉可能的 PTCitis。评估 PTCitis 与人口统计学和临床病理发现的关系。进行逻辑回归分析以确定 PTCitis 的预测因素。

结果

在 90 例(53.3%)患者中发现了肾小管周围毛细血管炎,其中 57 例(33.7%)、31 例(18.3%)和 2 例(1.2%)患者的评分分别为 1、2 和 3。PTCitis 发生率最高的是少免疫性肾小球肾炎。在单因素分析中,男性、间质炎症存在、少免疫性肾小球肾炎和较高的血清肌酐水平与 PTCitis 风险增加相关,而严重的间质纤维化/肾小管萎缩与风险降低相关。间质炎症存在(比值比 [OR],5.94 [95%置信区间 (CI),1.41-25.03];P =.015)、少免疫性肾小球肾炎(OR,3.08 [95% CI,1.01-9.36];P =.048)和较高的血清肌酐水平(每 1mg/dL)(OR,1.56 [95% CI,1.14-2.11];P =.005)是多变量回归模型中 PTCitis 发展的独立预测因素。

结论

PTCitis 在原发性活检中很常见,在存在间质炎症、少免疫性肾小球肾炎和较高的血清肌酐水平时更有可能观察到。

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