背景:肾活检对于肾脏疾病的识别和管理至关重要。虽然被认为是侵入性手术,对于许多肾脏疾病的明确诊断和治疗是必要的。这项研究的主要目的是评估接受三级护理的儿童接受活检的肾脏疾病的临床病理方面。患者和方法:本横断面研究以肾病综合征住院的儿童(≤18岁)为研究对象,综合评估证实需要进行肾脏活检.包括277名符合纳入和排除标准的儿童。关于患者结果的数据,活检适应症,并发症,组织病理学结果,并记录了人口统计信息。结果:在277例接受肾活检的患者中,63.2%为男性,女性占36.8%。患者平均年龄为15±2.9岁,年龄分布在3至18岁之间。肾活检最常见的指征是<1岁和>10岁的非典型年龄(91.7%),类固醇抗性(5.1%),无症状性血尿(21.3%),肾小球滤过率异常(16.2%),和蛋白尿(14.8%)。最常见的组织病理学发现是局灶节段肾小球硬化(FSGS)(36.5%),其次是微小病变(MCD)(13.4%),膜增生性肾小球肾炎(MPGN)(10.5%),膜性肾小球肾炎(MGN)(7.94%),IgA肾病(IGAN)(7.58%),非增生性肾小球肾炎(NPGN)(7.58%),弥漫性增生性肾小球肾炎(DPGN)(6.9%),月牙形GN(5.8%),系统性红斑狼疮(SLE)(3.97%)。在SLE中看到了高频率的阳性样本,其次是DPGN,MPGN,IGAN,和MGN。相比之下,MCD,CrescenticGN,NPGN在所有差分项功能(DIF)参数中都显示出负。结论:肾活检是诊断和治疗小儿肾病综合征安全有效的方法。FSGS在检查的活检中频率最高。
Background: A renal biopsy is essential for the identification and management of renal disorders. Although considered an invasive operation, it is necessary for a definitive diagnosis and treatment of many renal diseases. The primary goal of this study was to assess the clinicopathological aspect of renal diseases undergoing biopsy in children receiving tertiary care.Patients and Methods: Children (≤18 years) hospitalized with nephrotic syndrome were the subjects of this cross-sectional study, and comprehensive assessments confirmed the need for a kidney biopsy. Included were 277 children who met the inclusion and exclusion criteria. Data on patient outcomes, biopsy indications, complications, histopathologic results, and demographic information were documented.Results: Of the 277 patients who underwent renal biopsy, 63.2% were male, and 36.8% were female. Average age of the patients was 15 ± 2.9 years, with age distribution ranging from 3 to 18 years. The most frequent indication for renal biopsy was atypical age of <1 and >10-years-old (91.7%), steroid-resistant (5.1%), asymptomatic hematuria (21.3%), abnormal glomerular filtration rate (16.2%), and proteinuria (14.8%). The most common histopathological findings were focal segmental glomerulosclerosis (FSGS) (36.5%), followed by minimal change disease (MCD) (13.4%), membranoproliferative glomerulonephritis (MPGN) (10.5%), membranous glomerulonephritis (MGN) (7.94%), IgA nephropathy (IGAN) (7.58%), non-proliferative glomerulonephritis (NPGN) (7.58%), diffuse proliferative glomerulonephritis (DPGN) (6.9%), crescentic GN (5.8%), and systemic lupus erythematosus (SLE) (3.97%). The high frequency of positive samples was seen in SLE, followed by DPGN, MPGN, IGAN, and MGN. In contrast, MCD, crescentic GN, and NPGN showed negativity in all differential item functioning (DIF) parameters.Conclusion: Renal biopsy is a safe and effective procedure in the diagnosis and treatment of in children with nephrotic syndrome. FSGS had the highest frequency in examined biopsies.