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Register a new userHistological Findings in Renal Biopsies in Patients with Glomerular and Lupus Nephropathies
الموجودات النسيجية في خزعات الكلية عند مرضى الاعتلالات الكبية و الذأبية
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Tishreen University ورقة بحثية
Publication date
2013
fields
Medicine
and research's language is
العربية
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Shamra Editor
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إن كثرة شيوع الأمراض الكلوية يجعلها من الأمور الهامة طبياً، و لمعرفة تواتر الأمراض الكلوية في سورية و مقارنتها بالدراسات العالمية قمنا بدراسة 261 خزعة كلية مجراة لمرضى في الفترة ما بين (1/1/2007-31/12/2012) في مشفى الأسد الجامعي في دمشق, فحصت بالمجهر الضوئي و مجهر الومضان المناعي. مئة و عشرة خزعات كانت التهاب كبب و كلية بدئي بنسبة 59.8% من 184 خزعة فيها آفة كبية، أشيع نمط من التهاب الكبب و الكلية البدئي كان التصلب الكبي القطعي البؤري FSGS بنسبة (30.9% )، ثم جاء الاعتلال الكبي الغشائي MN بنسبة (29.1 %) ثم وجد الاعتلال الكلوي بـ (IgA (IgAN بنسبة 10%، و قد تساوت حالات التهاب الكبب و الكلية الغشائي التكاثري MPGN و الداء الكبي قليل التبدلات MCD بنسبة 9.1%، أما التهاب الكبب و الكلية الهلالي CrGN فقد كان بنسبة 6.4% و أخيراً كان التهاب الكبب و الكلية التالي للإنتان PIGN بنسبة 5.5 %. أما بالنسبة التهاب الكبب و الكلية الثانوي فوجدت 74 حالة بما نسبته 40.2% من خزعات الآفات الكبية، و كان التهاب الكلوي الذأبي LN أكثرها تواتراً 85.1% ثم التصلب الكبي السكري بنسبة 8.1 % ثم الداء النشواني بنسبة 6.8%.
Renal diseases are an important medical subject because of their prevalence, so to know frequency of glomerular diseases in Syria and compare it with international studies we studied 261 renal biopsies over a period (1/1/2007–31/12/2012), in Al Assad Hospital of the University in Damascus, investigated by light microscopy immunofluorescence. One hundred and ten cases (59.8%) were primary glomerulonephritis from 184 cases of glomerular disease focal/segmental glomerulosclerosis FSGS was the most common type of primary glomerulonephritis found (30.9%) of primary glomerulonephritis), followed by membranous nephropathy(MN) in 29.1 % , IgAnephropathy (IgAN) in 10%, then membranoproliferative glomerulonephritis (MPGN) and minimal change disease(MCD) 9.1% and, crescentic glomerulonephritis (CerGN) in 6.4% and finally postinfectious glomerulonephritis (PIGN) 5.5 % of the secondary glomerulonephritis were (74 cases constituting 40.2% of the biopsies) lupus nephritis(LN) was the most frequently diagnosed disease (85.1% of secondary glomerulonephritis) diabetic nephropathy (DN) was found in 8.1% of cases amyloidosis (AMD) in 6.8%.
Artificial intelligence review:
Research summary
تتناول هذه الدراسة التي أجراها الدكتور شريف السالم وعزيزة المكن، تحليل نتائج 261 خزعة كلوية تم إجراؤها في مشفى الأسد الجامعي بدمشق بين عامي 2007 و2012. الهدف من الدراسة هو معرفة تواتر الأمراض الكلوية في سوريا ومقارنتها بالدراسات العالمية. تم تحليل الخزعات باستخدام المجهر الضوئي ومجهر الومضان المناعي. أظهرت النتائج أن 59.8% من الخزعات كانت تعاني من التهاب كبب وكلية بدئي، وكان التصلب الكبي القطعي البؤري (FSGS) هو النمط الأكثر شيوعاً بنسبة 30.9%. أما بالنسبة للالتهابات الكلوية الثانوية، فقد كان التهاب الكلية الذأبي (LN) هو الأكثر شيوعاً بنسبة 85.1%. الدراسة أكدت على أهمية التعاون بين المشرح المرضي والطبيب السريري للوصول إلى تشخيص دقيق.
Critical review
دراسة نقدية: تعتبر هذه الدراسة مهمة جداً لفهم تواتر الأمراض الكلوية في سوريا، ولكن هناك بعض النقاط التي يمكن تحسينها. أولاً، كان من الأفضل لو تم استخدام المجهر الإلكتروني في جميع الحالات وليس فقط في بعض الحالات الضرورية، لأن ذلك قد يعطي نتائج أكثر دقة. ثانياً، الدراسة اعتمدت بشكل كبير على المجهر الضوئي والومضان المناعي، وكان من الممكن توسيع نطاق الأدوات المستخدمة لتشمل تقنيات أحدث. ثالثاً، كان من الممكن تقديم تحليل أكثر تفصيلاً للعوامل البيئية والاجتماعية والاقتصادية التي قد تؤثر على تواتر الأمراض الكلوية في سوريا. وأخيراً، كان من الممكن تضمين عدد أكبر من الخزعات من مختلف المحافظات لضمان تمثيل أكثر دقة لتوزيع الأمراض على مستوى البلاد.
Questions related to the research
-
ما هو الهدف الرئيسي من هذه الدراسة؟
الهدف الرئيسي هو معرفة تواتر الأمراض الكلوية في سوريا ومقارنتها بالدراسات العالمية.
-
ما هو النمط الأكثر شيوعاً من التهاب الكبب والكلية البدئي في الدراسة؟
النمط الأكثر شيوعاً هو التصلب الكبي القطعي البؤري (FSGS) بنسبة 30.9%.
-
ما هي النسبة المئوية للالتهابات الكلوية الثانوية الأكثر شيوعاً في الدراسة؟
الالتهاب الكلوي الذأبي (LN) هو الأكثر شيوعاً بنسبة 85.1%.
-
ما هي الأدوات المستخدمة في تحليل الخزعات الكلوية في هذه الدراسة؟
تم استخدام المجهر الضوئي ومجهر الومضان المناعي لتحليل الخزعات.
References used
COTRAN, R. S' KUMAR, V' et al. Robbins and Cotran Pathologic Basis of Disease.8th edit, saunders Co,2010 ,chapter 20
LEVEY, A.S' CORESH, J' BALK, E' KAUSZ, A.T, LEVIN, A' STEFFES, M.W' et al. National Kidney Foundation practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Ann Intern Med 2003; 139: 137-147
L.S. Li . End-stage renal disease in China .Kidney Int, 49 (2003), pp, 287–301
Tryggvason K, Patrakka J, Wartiovaara J. Hereditary proteinuria syndromes and mechanisms of proteinuria. N Engl J Med 2006;354:1387-401
FUIANO, G' MAZZA, G' COMI, N' CAGLIOTI, A' De NICOLA, L' IODICE, C' et al. Current indications for renal biopsy: a questionnaire-based survey. Am J Kidney Dis 2000;35:448-57
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Early and accurate detection of kidney involvement in primary and secondary glomerulopathy, and therapeutic regimen mayimprove outcomes. Renal biopsy is required for definitive diagnosisof renal disease.
This study investigated whether patients with
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renal biopsy
proteinuria
(Focal Segmental Glomerulosclerosis (FSGS
(Membranous Nephropathy (MN
(Lupus Nephritis (LN
(Membranoproliferative Glomerulonephritis (MPGN
(Minimal Change Disease (MCD
خزعة الكلية
بيلة بروتينية
تصلب كبي قطعي بؤري
التهاب كبب و كلية غشائي تكاثري
اعتلال كلوي ذئبي
اعتلال كلوي غشائي
الداء قليل التبدلات
المزيد..
Back pound: Patients with end stage renal disease (ESRD) and lower urinary tract anomalies (LUTA) are often considered high risk for renal transplantation.
Methods and subjects: To evaluate the degree of risk, we have reviewed our experience of 17 p
atients with (ESRD) and (LUTA). The study was carried out in Almoussat university hospital, between 5/ 2003 and 5/2009. After a detailed urological assessment, the patients had been undergone either non-continent cutaneous diversion (Bricker) (Two patients) or continent cutaneous diversion with bladder augmentation (14 patients), before renal transplantation.
Results: The patient and graft survival rates were 84.62% and 100%, respectively. The presence of an ileal conduit did not adversely affect graft survival. And the commonest complication was persistent urinary tract infection, which occurred in all patients (100%), but didn’t cause any graft loss. However two patients died because of systemic infections and their graft function was
good.
Conclusion: Renal transplantation is a satisfactory option for patients with ESRD due to LUTA, but it is important to carry out detailed urological assessment prior to the transplant procedure.
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influence on patient and graft survival . There are a lot of factors that play are a role in incidence of these
vascular compilations as technical and anatomical ones .
the aim
is to determine the incidence of vascular complications in kidney transplant
patients in addition to signs and symptoms related to these complications, diagnosis modalities,
management and results.
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