Comparison and clinical analysis of pathological types of primary glomerular diseases in North Henan and Hainan

Objective To retrospectively review the compositions and evolutionary characteristics of primary glomerular diseases in North Henan and Hainan over the last 12 years.Methods A comparative analysis was conducted for 3985 cases of primary glomerular disease diagnosed by renal biopsy.From January 2008 to December 2019,the relevant clinicopathological data were divided into three groups according to the periods of 2008-2011,2012-2015 and 2016-2019.Then the changing trend of pathological type of disease was analyzed.Results The male-to-female radio was 1.22∶1 in North Henan area.MN(membranous nephropathy)was the most common type,accounting for around 40.1%.Its incidence has declined recently.The incidence of MN rose from 1.74% to 56.5%(2008-2017)and declined from 56.5% to 51.0%(2017-2019).However,it has remained the most important pathological type in primary renal diseases.IgAN(IgA nephropathy)ranked second,accounting for around 26.0%.Among the 160 patients in Hainan,the ratio of male-to-female was around 1.25∶1.IgAN and MsPGN(mesangial proliferative glomerulonephritis)accounted for 36.3% and 17.5% respectively.The peak age of incidence was between 19 to 40 years.It indicated that the disease predominated in young-aged group and the average age was(39.55±16.91)and(33.8±12.1)years respectively at two centers.MN patients were clustered in middle-aged group while MCD(minimal change disease),MsPGN and IgAN were more common in young-aged group.A comparison of primary glomerulonephritis among three groups in northern Henan showed statistical significance(P<0.05)while a comparison of minor degenerative nephropathy among three groups in Hainan showed statistical significance(P<0.05).Nephrotic syndrome was a major clinical manifestation in renal biopsy patients in both regions and latent glomerulonephritis was the rarest clinical manifestation.IgAN was the most common pathological type of nephritis.MN was the most common type of nephrotic syndrome.Conclusions MN was the most common one in North Henan.Since 2017,the composition ratios of MN and MCD have shown a downward trend while other pathological types remain basically unchanged.IgAN was the most common in Hainan,followed by MsPGN and MN.IgAN showed an upward trend and MCD showed a downward trend.The incidence rate of MN in North Henan was higher than that in Hainan.