The Spectrum of Biopsy-Proven Glomerular Diseases among Children in China

Abstract

The spectrum of glomerular diseases among children varied across sexes, age groups, and regions and changed substantially from 2004 to 2014 in China.

Evolving Epidemiology of Pediatric Glomerular Disease

“…The proportion of children with FSGS increased in the adolescent age group compared with the younger children in the NEPTUNE study in contrast to the Chinese cohort, where FSGS was less common in adolescents. The proportion of children with minimal change disease in the study by Nie et al increased over time (2), which might be explained by increased availability of electron microscopy data for biopsies over the study period or changing indications for kidney biopsy in this population. There is a chance that segmental glomerular scarring was missed in some children classified as "minimal change disease" because only five glomeruli were required for inclusion of the biopsy in this study.…”

“…Similarly, there is no consensus approach to which children with Henoch-Schönlein purpura nephritis (IgA vasculitis) should receive a kidney biopsy. The results of the study by Nie et al (2) are somewhat difficult to interpret in the setting of the vast increase in kidney biopsies performed over the decade. Evolving biopsy practice patterns and expanding indications for biopsy may have significantly influenced the frequency of biopsies performed.…”

“…Is the incidence of glomerular disease changing over time and what does this mean for the role of environment in the pathogenesis? An article by Nie et al (2) in this issue of the Clinical Journal of the American Society of Nephrology provides much needed data about the frequency of biopsy-proven glomerular disease in children in China. This report is notable for the sheer volume of pediatric biopsies that were available for analysis.…”

“…Nie et al (2) have reported, for the first time, a large epidemiologic overview of glomerular disease in Chinese children. This study highlights the power of collaborative research networks for studying kidney disease in children, as well as the need to support epidemiologic studies in diverse geographic and ethnic populations.…”

“…This, of course, will require international cooperation because of the rare nature of these diseases in children. Studies such as Nie et al's (2), that help us understand the variability in prevalence of glomerular disorders by region, are important in planning for future studies and suggest that clinical trial enrollment should require kidney biopsy for inclusion.…”