Changes of kidney disease spectrum in Wenzhou area in recent 10 years: a retrospective study of 5 114 biopsy-proven cases
Lin Sishi 1, 2, Chen Bo 1, 2, Zhou Ying 1, 2, You Xiaohan 1, 2, Zhang Jianna 1, 2, Chen Xinxin 1, 2, Ding Xiaokai 1, 2, Zhang Ji 1, 2, Chen Chaosheng 1, 2.
1.Department of Nephrology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325015, China; 2.Institute of Chronic Kidney Disease, Wenzhou Medical University, Wenzhou 325035, China
Lin Sishi,Chen Bo,Zhou Ying, et al. Changes of kidney disease spectrum in Wenzhou area in recent 10 years: a retrospective study of 5 114 biopsy-proven cases[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2022, 52(1): 15-22.
摘要目的：分析温州地区近十年肾脏疾病谱的构成特征和流行病学趋势。方法：选取2009年10月至2019年9月在温州医科大学附属第一医院行肾脏病理检查的患者，按照时间分布分为2个阶段，即2009年10月至2014年9月为第一阶段（组1），2014年10月至2019年9月为第二阶段（组2），分析肾脏疾病的构成和演变。结果：本研究共纳入肾穿刺活检标本5 114 例，肾活检患者平均年龄随时间变化逐渐升高，老年患者肾活检比例由7.70%升至20.36%。与组1相比，组2膜性肾病比例明显升高（24.3% vs. 36.8%，P ＜0.001），其中以45～59岁年龄段增长幅度最显著。继发性肾小球疾病主要包括免疫介导性疾病（55.0%）、肿瘤代谢性疾病（33.8%）和感染相关性肾病（3.7%），两组相比，组2中肿瘤代谢性疾病比例升高近1倍（24.0% vs. 44.4%，P ＜0.001）。结论：在过去的10年中，温州地区的肾脏疾病谱中原发性肾小球疾病中膜性肾病比例明显升高，是中老年患者最常见的原发性肾小球疾病。在继发性肾小球疾病中，糖尿病肾病、肾淀粉样变性等肿瘤代谢性疾病比例明显升高。
Abstract：Objective: To analyze the composition and epidemiological trend of kidney disease spectrum in Wenzhou area in the past decade. Methods: A total of 5 114 biopsy-proven cases diagnosed in the Division of Kidney Pathology the First Affiliated Hospital of Wenzhou Medical University, from October 2009 to September 2019, were included in this study. They were divided on a 5-year basis as group 1 (October 2009 to September 2014) and group 2 (October 2014 to September 2019), with an analysis of the composition and evolution of kidney diseases. Results: The patients’ mean age at biopsy increased with time, and the proportion of the elderly patients
who received renal biopsy increased from 7.70% to 20.36%. Compared with group 1, group 2 had significantly increased the proportion of membranous nephropathy (MN) (24.3% vs. 36.8%, P<0.001), especially in the 45-59 age category. The secondary glomerular disease (SGD) mainly composed of immune-mediated diseases (55.0%),tumor-associated or metabolic diseases (33.8%) and infection-associated diseases (3.7%). Compared with group1, group 2 had nearly doubled proportion of tumor-associated or metabolic diseases (24.0% vs. 44.4%, P<0.001).Conclusion: In the past 10 years, the kidney disease spectrum in Wenzhou area has changed significantly. The proportion of MN was significantly increased and has become the most common PGD among middle-aged and elderly patients. In addition, the proportion of tumor-associated or metabolic diseases such as diabetic nephropathy and renal amyloidosis increased significantly.
