在斯里兰卡对过去 10 年中超过 3000 例肾活检进行的回顾性研究中，肾小管间质性肾病是男性中最主要的发现。

Tubulointerstitial nephropathy is the predominant finding in men in a review of more than 3000 renal biopsies over a 10-year period from Sri Lanka.

机构信息

School of Population Health, University of New South Wales, UNSW, Sydney, Australia.

The George Institute for Global Health, Sydney, Australia.

出版信息

BMC Nephrol. 2024 Sep 6;25(1):295. doi: 10.1186/s12882-024-03731-7.

DOI:10.1186/s12882-024-03731-7

PMID:39243033

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11378423/

Abstract

BACKGROUND

Chronic kidney disease (CKD) is a significant clinical challenge in Sri Lanka. The present study presents histopathological diagnoses from native renal biopsies in Kandy District, 2011-2020.

METHODS

Reports of 5,014 renal biopsies principally performed at Kandy Teaching Hospital over 2011-2020 were reviewed. After exclusions for post-kidney transplant biopsies (1,572) and those without evident pathology (347), 3,095 biopsies were included. The predominant histopathological entities were grouped and categorised according to diagnosis and stratified by age and sex.

RESULTS

The main histopathological entities (all biopsies) were tubulointerstitial nephropathy (TIN) 25% (n = 760), glomerulonephritis (GN) 15% (467), lupus nephropathy 14% (429), focal segmental glomerular sclerosis (FSGS) 10% (297), and IgA nephropathy (IgAN) 8% (242). For adult women ≥ 15 years, the main histopathological entities were lupus nephropathy 24% (325), TIN 17% (228), and GN 16% (217). For adult men ≥ 15 years, the main histopathological entities were TIN 34% (449), GN 14% (180), and IgAN 10% (125). The proportion of TIN in the present study was higher than international studies of a similar size.

CONCLUSION

This is the largest study of renal biopsies reported from Sri Lanka to date. TIN was the most common diagnosis in adults ≥ 15 years at 25%. Notable sex differences showed TIN was the most common histopathology in men (34%) but not in women (17%). No previously published similar study of this size has found TIN as the predominant diagnosis amongst renal biopsies in men. Further research is required into the possible causes of these observations in Sri Lanka.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

慢性肾脏病（CKD）是斯里兰卡面临的重大临床挑战。本研究呈现了 2011 年至 2020 年期间康提地区的原发性肾活检的组织病理学诊断结果。

方法

对 2011 年至 2020 年期间主要在康提教学医院进行的 5014 例肾活检报告进行了回顾。排除肾移植后活检（1572 例）和无明显病理的活检（347 例）后，纳入了 3095 例活检。根据诊断将主要组织病理学实体进行分组和分类，并按年龄和性别分层。

结果

主要的组织病理学实体（所有活检）为小管间质性肾病（TIN）占 25%（760 例）、肾小球肾炎（GN）占 15%（467 例）、狼疮性肾炎（LN）占 14%（429 例）、局灶节段性肾小球硬化症（FSGS）占 10%（297 例）和 IgA 肾病（IgAN）占 8%（242 例）。对于成年女性（≥15 岁），主要的组织病理学实体为狼疮性肾炎占 24%（325 例）、TIN 占 17%（228 例）和 GN 占 16%（217 例）。对于成年男性（≥15 岁），主要的组织病理学实体为 TIN 占 34%（449 例）、GN 占 14%（180 例）和 IgAN 占 10%（125 例）。与类似规模的国际研究相比，本研究中 TIN 的比例更高。

结论

这是迄今为止斯里兰卡报告的最大规模的肾活检研究。在≥15 岁的成年人中，TIN 是最常见的诊断，占 25%。值得注意的是，在性别差异方面，TIN 是男性（34%）最常见的组织病理学表现，但在女性（17%）中并非如此。此前没有类似规模的研究发现 TIN 是男性肾活检的主要诊断。需要进一步研究造成这些观察结果的可能原因。