Pathological spectrum of glomerular disease in patients with renal insufficiency: a single-center study in Northeastern China

Abstract

Background: To investigate the pathological spectrum of glomerular disease in patients with renal insufficiency (RI) from 2008 to 2017. Methods and results: We calculated the estimated glomerular filtration rate (eGFR) with the Chronic Kidney Disease Epidemiology Collaboration creatinine (CKD-EPI) equation and defined RI as an eGFR <60 ml/min/1.73 m 2 . A total of 969 RI patients were included in our study. IgA nephropathy (IgAN) was the most common subtype of primary glomerulonephritis (37.2%). The frequencies of IgAN and non-IgA mesangioproliferative glomerulonephritis decreased from 27.3% and 9.5% during 2008-2012 to 20.7% and 2.6% during 2013-2017, respectively. However, the frequency of membranous nephropathy increased from 6.8% to 16.2%. Lupus nephritis was the most common subtype of secondary glomerulonephritis (32.1%). The frequencies of both ANCA-associated systemic vasculitis and diabetic nephropathy increased from 3.8% to 7.6% and from 4.3% to 7.6%, respectively. The number of elderly patients (!60 years) in our study increased sharply, from 15.6% in 2008 to 35.0% in 2017. Membranous nephropathy, minimal change disease, membranoproliferative glomerulonephritis, lupus nephritis and renal amyloidosis are more frequently observed in the elderly patients than in nonelderly patients (<60 years) (p < .05). Excluding those with acute kidney injury, IgAN was the leading cause of RI (24.9%), followed by membranous nephropathy (13.3%) and lupus nephritis (12.0%). Conclusions: IgAN and lupus nephritis were the most prevalent primary glomerulonephritis and secondary glomerulonephritis in patients with RI, respectively. The frequencies of membranous nephropathy, ANCA-associated systemic vasculitis and diabetic nephropathy increased significantly. The number of elderly patients with RI increased sharply. ARTICLE HISTORY

Clinical and pathological analysis of renal biopsies of elderly patients in Northeast China: a single-center study

“…The percentage of elderly patients undergoing renal biopsy in our center is similar to that in previous reports [11]. As previously reported in multiple studies [12][13][14][15][16], the percentage of elderly patients undergoing renal biopsy, over the years, has increased in our center. Among elderly and non-elderly patients with renal disease, the risk of undergoing renal biopsy is comparable [6,17].…”

The spectrum of biopsy-proven renal diseases in Korea

“…Recent studies from China showed that membranous nephropathy is increasing [6,11], and this result might be associated with air pollution by particulate matter 2.5 (PM 2.5 ) [12]. However, the current study [9] did not show any significant change in frequency of membranous nephropathy according to time course.…”

A Spectrum of Biopsy – Proven Renal Disorders and Their Clinicopathological Correlation in Elderly Population From a Tertiary Care Center in South India

“…Our study also showed a similar pattern of renal injury in the form of rising creatinine or proteinuria, among many patients diagnosed with renal failure secondary to hypertension (58%). Renal vasculitis is more common in the elderly than in the young [ 1 , 6 ]. Only 2.2% of our cases showed crescentic glomerulonephritis.…”

“…CKD is a common public health-related issue with a higher incidence rate and poorer prognosis in recent years. It is a financially challenging disease globally and is frequently seen in older adults [ 1 ]. As the life span of individuals increases, the patients with acute and chronic kidney disease continue to survive longer [ 2 ].…”