Single centre clinico-pathological analysis of 1 579 renal biopsies in children

Objective To investigate the clinical features and pathological characteristics as well as their associations with secular trend of the disease of 1 579 pediatric renal biopsies.Methods The clinical and pathological data were retrospectively analyzed in 1 579 children with renal diseases with biopsy performed from 1989 to 2012 in our hospital. The changes of clinical and pathological type distribution were characterized in every 5 years historically in different age groups ( -1, -3, -6, -12, -18 years) and genders.Results ①The mean age of 1 579 children was (9.3±3.2) years (4 months to 18 years). The ratio of males to females was 1.92. Primary glomerulonephritis (PGN), secondary glomerulonephritis (SGN) and inherited nephropathy accounted for 60.1%, 31.2% and 8.3% of the total cases. The PGN and SGN mainly included nephritic syndrome (NS), isolated hematuria, acute glomerulonephritis(AGN) and Henoch-schonlein purpura nephritis(HSPN), HBV-associatied glomerulonephritis(HBVGN), lupus nephritis(LN), respectively. The pathological classification of PGN mainly included minimal change disease/mild disease (MCD/ML), IgAN and mesangial proliferative glomerulonephritis(MsPGN). ②Male patients dominated in NS, HBVGN and Alport syndrome, however, female dominated in isolated hematuria, rapidly progressive glomerulonephritis(RPGN), LN, ANCA-associated glomerulonephritis and thin basement membrane disease. The proportions of NS, isolated hematuria, AGN, CGN, HBVGN, LN and hemolytic uremic syndrome significantly changed with age. ③The clinical patterns of PGN were significantly correlated with the distribution of pathological types. The main pathological patterns of NS were MCD/ML, IgMN and IgAN. The main pathological patterns of hematuria were MCD/ML, IgAN and MsPGN. The main pathological patterns of hematuria with proteinuria were IgAN and MsPGN. The main pathological patterns of RPGN and chronic glomerulonephritis(CGN) were crescentic glomerulonephritis(CreGN) and sclerosing glomerulonephritis(SGN), respectively. ④The spectrum of NS, HSPN, HBVGN, IgAN was changed in 23 years.Conclusions There were some relationships between the clinical and pathological features to gender and age in children. Renal biopsy is valuable in the diagnosis and treatment in children with renal diseases.