Distribution of pathological types and epidemiological characteristics based on kidney biopsy in Northwest China

Abstract

Background: The spectrum of biopsy-confirmed kidney disease varies with regions and periods. We describe the distribution ofpathological types and epidemiological characteristics of kidney diseases in Northwest China due to regional differences in geographicalenvironment, social economy, and dietary habits.Methods: Kidney biopsy cases from 2005 to 2020 in Xijing Hospital were retrospectively analyzed. Pathological characteristics of patientsin different periods were analyzed using the t test or chi-square test. Joinpoint regression was used to analyze trends in pathologicaltypes and disease spectrum.Results: A total of 10,528 eligible patients were included. Primary glomerular disease (PGD) accounted for the majority of the casesand exhibited an obvious downward trend, whereas secondary glomerular disease (SGD) showed an obvious upward trend. AmongPGD, immunoglobulin A nephropathy (IgAN) remained the most common pathological type, and the detection rate of membranousnephropathy (MN) was significantly increased. Among SGD, Henoch-Schönlein purpura nephritis (HSPN) was the most commonpathological type and may present a significant characteristic of Northwest China. Diabetic nephropathy (DN) exhibited the most obviousupward trend in the whole process, whereas the fastest growth since 2012 was in hypertensive nephropathy.Conclusion: The proportion of SGD increased whereas PGD declined. IgAN remained the most common PGD, and HSPN was themost common SGD. MN and DN showed the most obvious upward trend among PGD and SGD, respectively. Changes in the spectrumof kidney disease, especially the constituent ratio of SGD, pose a great challenge to public health.