The Spectrum of Biopsy-Proven Glomerular Disease in China: A Systematic Review

• Published in: Chinese medical journal Vol. 131; no. 6; pp. 731 - 735
• Main Authors: Yang, Yue, Zhang, Zheng, Zhuo, Li, Chen, Da-Peng, Li, Wen-Ge
• Format: Journal Article
• Language: English
• Published: China Wolters Kluwer India Pvt. Ltd 20.03.2018; Medknow Publications and Media Pvt. Ltd; Lippincott Williams & Wilkins Ovid Technologies; Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China%Department of Nephrology, China-Japan Friendship Hospital, Beijing 100029, China; Institute of Basic Medicine, Peking Union Medical College, Beijing 100005, China; Medknow Publications & Media Pvt Ltd; Wolters Kluwer
• Subjects: Biopsy; Biopsy - methods; Diabetic nephropathy; Glomerulonephritis - diagnosis; Glomerulonephritis - metabolism; Hospitals; Humans; Kidney diseases; Medical research; Methods; Nephrology; Outdoor air quality; Prevalence studies (Epidemiology); Primary Glomerulus Nephritis; Renal Biopsy; Secondary Glomerulus Nephritis; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - metabolism; Review; Statistics; Studies; Systematic review; Trends; China; Brazil; Beijing China; Japan; Renal Biopsy; Secondary Glomerulus Nephritis; Primary Glomerulus Nephritis
• ISSN: 0366-6999; 2542-5641; 2542-5641
• DOI: 10.4103/0366-6999.226906

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.