The Spectrum of Biopsy-Proven Glomerular Disease in China

Abstract

Background:Chronic kidney disease has become a leading public health concern in China, as it is associated with increased morbidity, mortality, and costs. However, the overall situation regarding common glomerular diseases in China remains unclear. Hence, the aim of this study was to assess the national profile of the common types of glomerulonephritis in China.Methods:We searched Medline, Embase, Cochrane Library, CNKI, SinoMed, VIP, and Wanfang databases for English and Chinese language articles from inception to September 2017. We also collected potentially relevant studies and reviews using a manual search. The following words in combinations are as keywords: “renal biopsy”, “kidney pathological diagnosis”, and “spectrum of pathological types”.Results:We identified 23 studies involving 176,355 patients from 15 provinces/cities in China. The detection rates of primary glomerulonephritis (PGN) and secondary glomerulonephritis (SGN) were 0.740 and 0.221, respectively. Over the past 30 years, the top five types of PGN were immunoglobulin A nephropathy (IgAN; 24.3%), mesangial proliferative glomerulonephritis (MsPGN; 10.5%), membranous nephropathy (MN; 12.6%), minimal change disease (MCD; 9.8%), and focal segmental glomerulosclerosis (FSGS; 4.6%), and the top four types of SGN were lupus nephritis (LN; 8.6%), Henoch-Schönlein purpura glomerulonephritis (4.1%), hepatitis B virus-associated glomerulonephritis (HBV-GN; 2.6%), and diabetic nephropathy (DN; 1.6%). The proportion of MN, MCD, HBV-GN, and DN tended to increase, while those of IgAN, MsPGN, FSGS, and LN tended to drop.Conclusions:Although the incidence of SGN is increasing gradually, PGN is still the leading form of kidney disease in patients undergoing renal biopsies in China. IgAN and LN are the most common types of PGN and SGN, respectively. Differences between regions are related to various factors such as nationality, environment, and diet. Furthermore, unified standards and norms for evaluating renal biopsies are urgently needed.

Clinical and Pathological Analysis of 4910 Patients Who Received Renal Biopsies at a Single Center in Northeast China

“…The prevalence of different pathological types of renal diseases varies with patient age, geographic origin, and ethnic group. Recent studies showed that primary glomerulonephritis (PGN) is the most common glomerulonephritis in China in that it accounts for 61.7 to 74.0% of all incident cases [4–9]. In recent years, the incidence of secondary glomerulonephritis (SGN) has increased in China [7].…”

Clinical value of a serum anti-PLA2R antibody in the diagnosis and monitoring of primary membranous nephropathy in adults

“…2 With the populariza-tion of renal pathological diagnosis methods, most medical centers have reported that the incidence rates of MN are increasing year by year. 3 Approximately one third of PMN patients have spontaneous remission, and one third to half of patients can progress to end-stage renal disease within 5-10 years if they are not diagnosed and treated promptly. 4 PLA2R is an autoantigen present in glomerular podocytes.…”

The trajectory of high sensitivity C-reactive protein is associated with incident diabetes in Chinese adults

“…The diseases themselves could increase the concentration of hs-CRP and its drugs used in these diseases might also increase the concentration of blood glucose as well. However, the incidence of these diseases in general population is low in China [31][32][33][34][35] and the dosage of corticosteroid during the quiescent phage of the diseases is low. We thus assumed the possible impacts of the diseases and its related treatment is minimal in the current study.…”