Clinical and pathological analysis of glomerular diseases in children in Chaoshan area

CHEN Cheng; LIN Guang-yu; WU Yang; ZHOU Xiao-hua

doi:10.13820/j.cnki.gdyx.20240592

Abstract：Objective To retrospectively analyze the clinical and pathological characteristics of pediatric glomeru-lar diseases in the Chaoshan area over the past 12 years and summarize the main features and trends of the disease spec-trum.Methods Clinical and pathological data of children under 14 years old diagnosed with glomerular diseases and who underwent successful renal biopsy at the Children's Hospital of Shantou University Medical College from January 2010 to December 2021 were collected and analyzed.The data were compared over three stages(P1:2010-2013,P2:2014-2017,P3:2018-2021)to analyze the changes in the disease spectrum.Results A total of 182 cases were included in the analysis,comprising 92 males(50.55％)and 90 females(49.45％)with a male-to-female ratio of 1.02:1.The average age was 8.1±3.4 years,with no significant changes in gender and age composition over time.Primary glomerular diseases accounted for 94 cases(51.7％),secondary glomerular diseases for 83 cases(45.6％),and hereditary glomer-ular diseases for 5 cases(2.7％).Compared to P2,the percentage of primary glomerular diseases in P3 significantly in-creased,while secondary glomerular diseases decreased(P＜0.05).The main clinical manifestations of primary glomeru-lar diseases included nephrotic syndrome(63.8％),isolated hematuria and/or proteinuria(26.6％),and acute glomer-ulonephritis(9.6％).Pathological types were predominantly minimal change disease(42.6％),IgA nephropathy(25.5％),focal segmental glomerulosclerosis(9.6％),mild glomerular changes(7.4％),and mesangial proliferative glomerulonephritis(6.4％).Over the past 12 years,the proportion of minimal change disease has significantly increased(P＜0.05),while focal segmental glomerulosclerosis also showed an upward trend,and the proportion of IgA nephropathy decreased in P3 compared to P2.Secondary glomerular diseases were primarily manifested as Henoch-Schönlein purpura nephritis(72.3％)and lupus nephritis(26.5％),with the proportion of Henoch-Schönlein purpura nephritis signifi-cantly increasing in P2 and P3 compared to P1(P＜0.05).Gender differences were statistically significant in different clinical and pathological types(P＜0.001);for primary glomerular diseases,except for mild glomerular changes,other types had a higher male proportion,with significant gender differences in minimal change disease and IgA nephropathy(P＜0.05).Conversely,in secondary glomerular diseases,females had a higher proportion in both Henoch-Schönlein purpura nephritis and lupus nephritis(P＜0.05).Conclusion Among the pediatric renal biopsies in the Chaoshan are-a,primary glomerular diseases were the most common,with the primary clinical manifestation being nephrotic syndrome and the most common pathological classification being minimal change disease.In recent years,the proportion of primary glomerular diseases has increased annually,while secondary glomerular diseases have decreased annually.