Renal biopsy reports in nephritic syndrome: Update

S. Taheri
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引用次数: 3

Abstract

BACKGROUND Nephritic syndrome (NiS) is a major indicator of serious renal diseases necessitating kidney biopsies for histopathological evaluations, but due to the lack of comprehensive reviews in the literature, the current understanding of the syndrome and its significance is limited. AIM To collect all the evidence retrievable from the literature on the diagnoses made on the renal biopsies performed for NiS as the indication to the procedure. METHODS A literature search was conducted to find studies reporting final diagnoses on renal biopsies in NiS patients. Data were pooled and analyzed with stratifications on age and regions. Meta-analyzes were performed using Stata v.9. RESULTS Overall, 26414 NiS patients from the total number of 96738 kidney biopsy diagnoses reported by 47 studies from 23 countries from all continents (except sub-Saharan Africa) were found and analyzed. NiS was the indication for renal biopsy in 21% of the patient populations across the reviewed studies. Immunoglobulin A (IgA) nephropathy was the single most frequent diagnosis in these patients (approximately 38%) followed by lupus nephritis (approximately 8%) and Henoch Schönlein purpura (approximately 7%). IgA nephropathy was the most frequent diagnosis reported for the NiS patients from the East Asia, comprising half of all the cases, and least prevalent in South Asia. Considering the age subgroups, adult (vs pediatric or elderly) patients were by far the most likely age group to be diagnosed with the IgA nephropathy. A myriad of such regional and age disparities have been found and reported. CONCLUSION As the indication for renal biopsy, NiS represents a very distinctive epidemiology of final renal disease diagnoses compared to the other major syndromes.
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肾病综合征的肾活检报告:更新
肾病综合征(nephrotic syndrome, NiS)是严重肾脏疾病的主要指标,需要进行肾脏活检进行组织病理学评估,但由于文献中缺乏全面的综述,目前对该综合征的认识及其意义有限。目的收集所有可从文献中检索到的关于NiS肾活检诊断作为手术指征的证据。方法:文献检索报告NiS患者肾活检最终诊断的研究。对数据进行汇总和分析,并按年龄和地区分层。meta分析使用Stata v.9进行。结果:总体而言,来自各大洲23个国家(撒哈拉以南非洲除外)的47项研究报告的96738例肾活检诊断中发现并分析了26414例NiS患者。在回顾的研究中,21%的患者群体的肾活检指征是NiS。免疫球蛋白A (IgA)肾病是这些患者中最常见的诊断(约38%),其次是狼疮肾炎(约8%)和Henoch Schönlein紫癜(约7%)。IgA肾病是东亚NiS患者中最常见的诊断,占所有病例的一半,而在南亚最不普遍。考虑到年龄亚组,到目前为止,成人(与儿童或老年人相比)患者是最有可能被诊断为IgA肾病的年龄组。人们已经发现并报道了无数这样的地区和年龄差异。结论与其他主要综合征相比,NiS作为肾活检的指征,在最终肾脏疾病诊断中具有非常独特的流行病学特征。
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