The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019

The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019 | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019 Li-Jun Jiang, Zan-Hua Rong, Xue Zhao, Zhi-Yan Dou, Lin Yang This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-140880/v2 This work is licensed under a CC BY 4.0 License Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Abstract Background: This study aimed to investigate the clinical and pathological characteristics and the changes in glomerular diseases in 2403 pediatric renal biopsies from 1999 to 2019. Methods: Renal biopsies performed on children aged ≤18 years between 1999 and 2019 were analysed at our center. We analysed the clinical and histological characteristics, distribution of pediatric glomerular diseases with various clinical presentations, and changes in the glomerular disease patterns during the study period. Results: The most common primary glomerular disease was IgA nephropathy (IgAN) (24.3%), followed by minimal change disease (MCD) (15.3%) and membranous glomerulonephritis (MN) (13.1%). Henoch-Schonlein purpura nephritis (HSPN) (18.1%) and lupus nephritis (LN) (7.2%) were the most frequently recorded secondary glomerular diseases. Alport syndrome and thin basement membrane nephropathy (TBMN) were the most common inherited glomerular diseases, accounting for 1.2% and 0.6% of the total glomerular diseases in children, respectively. The number of boys with IgAN, MCD and IgM nephropathy (IgMN) was higher than that of girls, while the number of girls with MN and LN was higher than that of boys. The frequencies of MCD, MN, IgMN and endocapillary proliferative glomerulonephritis (EnPGN) in the 13-18-year-old group were higher than those in the 0-12-year-old group, while the frequencies of IgAN, mesangial proliferative glomerulonephritis (MsPGN) and focal proliferative glomerulonephritis (FPGN) were lower than those in the 0-12-year-old group. The ratio of Alport syndrome and TBMN in the 0-12-year-old group was higher than that in the 13-18-year-old group. The proportion of patients with MCD and MN in 2010-2019 was higher than that in 1999-2009, while the ratio of IgAN, MsPGN, IgMN, EnPGN, membranoproliferative glomerulonephritis (MPGN), HSPN and HBV-associated glomerulonephritis (HBV-GN) decreased. MCD (28.5%) was the most common cause of nephrotic syndrome (NS). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more common than other glomerular diseases. IgAN (39.4%) was the most common cause of AKI. Sclerosing glomerulonephritis (SGN) (21.1%) was the main cause of progressive chronic kidney disease (CKD). Conclusions: Glomerular diseases in children were related to sex and age. From 1999 to 2019, the spectrum of children's kidney disease in our center changed significantly. Pediatrics Pediatric Renal biopsy Glomerular diseases Figures Figure 1 Background Chronic kidney disease (CKD) has become one of the major diseases threatening global public health [ 1 , 2 ]. It is a major chronic disease that causes a high medical burden and seriously affects quality of life. If CKD is not diagnosed and treated in time, the mortality of CKD will be significantly increased once it develops into end-stage renal disease (ESRD) [ 3 ]. Therefore, how to detect and treat CKD early in children is a clinical problem to be solved. The aetiology of CKD varies in different regions and ethnic groups. Congenital anomalies of the kidney and urinary tract (CAKUT) are the main causes of CKD in children in developed countries [ 1 , 4 , 5 ], while glomerular diseases are the main causes in developing countries [ 6 – 9 ]. Glomerular disease is still the main cause of CKD in children in China [ 6 ]. The diagnosis and treatment of glomerular diseases mainly depend on renal biopsy. Renal biopsy is an invasive procedure with the risk of haemorrhage and arteriovenous fistula. Therefore, it is very important to study the spectrum of glomerular diseases; the relationship between renal pathology and clinical manifestations; and the relationship between glomerular diseases and age, sex and years. This will correctly diagnose glomerular disease in children without renal biopsy. In China, there are few centers that study glomerular diseases in children. This study retrospectively analysed the clinical and pathological data of 2403 renal biopsies of children in a single center; clarified the constitution, changes and distribution of kidney diseases; and analysed them according to the patient's sex and age. Materials And Methods Inclusion and exclusion criteria From 1999 to 2019, we selected 2453 children with kidney disease under the age of 18 who underwent renal biopsy. The exclusion criteria were pathological results of renal biopsy with less than 5 glomeruli under a light microscope, incomplete clinical data, or tubulointerstitial disease or renal vascular disease without glomerular lesions. Finally, 50 cases were excluded, and 2403 cases were included in this analysis. The patients and/or parents signed the consent form before renal biopsy. The research was in compliance of the declaration of Helsinki and approved by the ethics committee of the Second Hospital of Hebei Medical University. Before enrollment, written informed consent was provided by patients or their guardians. Clinical Classification According to the clinical classification standard of children's glomerular disease formulated by the Chinese Medical Association in 2000, we divided 2403 children into six clinical types: nephrotic syndrome (NS), acute kidney injury (AKI), progressive CKD (defined as eGFR < 60 mL/min/1.73 m 2 ), proteinuria, haematuria, and proteinuria with haematuria. The glomerular filtration rate was calculated by the swatch formula. NS was defined as proteinuria greater than 50 mg/kg·d or greater than 3.5 g/kg and serum albumin less than 30 g/L. Proteinuria that does not meet the criteria for NS is defined as proteinuria. Indications And Contraindications For Percutaneous Renal Biopsy The indications for percutaneous renal biopsy include steroid-resistant NS, a part of steroid-dependent and frequently recurrent NS; NS with glomerular haematuria or renal insufficiency or hypertension or low complement; unexplained persistent haematuria and/or proteinuria; unknown AKI or unexplained progressive CKD; nephrotic proteinuria or NS or gross haematuria or AKI caused by Henoch-Schonlein purpura nephritis (HSPN); and other secondary glomerulonephritides. The contraindications for renal puncture include an isolated kidney, displaced kidney, abnormal renal structure, coagulation disorder, ESRD and renal infection. Pathological Examination All pathological tissues were examined by light microscopy and immunofluorescence, and approximately 50% of them were further examined by electron microscopy. Grouping According to age, they were divided into two groups: 0-12 years old and 13-18 years old. According to the time of renal puncture, they were divided into two groups: 1999-2009 and 2010-2019. According to sex, they were divided into male and female groups. According to the clinical classification of children's kidney disease, they were divided into 6 groups: NS, AKI, progressive CKD, proteinuria, haematuria and proteinuria with haematuria. The constituent ratios of renal pathology in different sexes, ages and years were compared. The constituent ratio of renal pathology corresponding to different clinical types was compared. Statistical analysis Data were expressed as the mean ± SD. The chi- square test was used to analyse the constituent ratio. SPSS 23.0 software was used for statistical analysis. A P value of ≤ 0.05 was considered to be statistically significant. Results General information A total of 2403 renal biopsy specimens were analysed from 1999 to 2019, including 1411 males and 992 females, with a male to female ratio of 1.4:1. The average age at renal biopsy was 13.5 ± 3.4 years old. The youngest was 1 month, 708 cases (29.5%) were 0-12 years old, and 1695 cases (70.5%) were 13-18 years old. From 1999 to 2009, 1055 patients (43.9%) underwent renal biopsy, and 1348 patients (56.1%) underwent renal biopsy from 2010 to 2019. The most common clinical syndrome was NS (50.1%), followed by haematuria and proteinuria (38.3%) (Table 1 ). Table 1 Demographic and clinical characteristics of 2403 children who underwent kidney biopsy 1999 to 2019 Characteristics Total,n=2403 Sex Male,n=1411 Female,n=992 Clinical syndrome,n(%) Nephrotic syndrome 1204(50.1) 665(47.1) 539(54.3) Haematuria and proteinuria 921(38.3) 561(39.8) 360(36.3) AKI 104(4.3) 68(4.8) 36(3.6) Haematuria 88(3.7) 56(4.0) 32(3.2) Proteinuria 67(2.8) 47(3.3) 20(2.0) Progressive CKD 19(0.9) 14(1.0) 5(0.5) Age,yr,mean(SD) 13.5(3.4) 13.5(3.4) 13.5(3.3) 0-12,n(%) 708(29.5) 402(28.5) 306(30.8) 13-18,n(%) 1695(70.5) 1009(71.5) 686(69.2) Time of kidney biopsy,n(%) 1999-2009 1055(43.9) 665(47.1) 390(39.3) 2010-2019 1348(56.1) 746(52.9) 602(60.7) Values are numbers(percentage). In this study, 1712 (71.2%) patients were diagnosed with primary glomerular disease, 648 (27.0%) patients were diagnosed with secondary glomerular disease, and 43 (1.8%) patients were diagnosed with hereditary glomerular disease. The most common primary glomerular disease was IgA nephropathy (IgAN) (24.3%), followed by minimal change disease (MCD) (15.3%) and membranous glomerulonephritis (MN) (13.1%). HSPN (18.1%) and lupus nephritis (LN) (7.2%) were more frequent in secondary glomerular diseases. Alport syndrome and thin basement membrane nephropathy (TBMN) were the most common inherited glomerular diseases, accounting for 1.2% and 0.6% of the total glomerular diseases in children, respectively (Figure 1 ). The Relationship Between Glomerular Diseases And Sex As described in Table 2 , the number of boys with IgAN, MCD and IgM nephropathy (IgMN) was significantly higher than that of girls, while the number of girls with MN was significantly higher than that of boys. In secondary glomerular diseases, the number of girls with LN was significantly higher than that of boys, and there was no significant difference in the proportion of HSPN between the two groups. There was also no significant difference in the proportions of Alport syndrome and TBMN between the two groups. Table 2 Relationship between glomerular diseases and sex Pathological classification Male Female P Value Primary glomerulonephritis 1073(76.0) 639(64.4) 0.000 IgAN 382(27.1) 201(20.3) 0.000 MCD 259(18.4) 109(11.0) 0.000 MN 156(11.1) 159(16.0) 0.000 GML 58(4.1) 34(3.4) 0.390 MsPGN 53(3.8) 38(3.8) 0.925 IgMN 61(4.3) 19(1.9) 0.001 FSGS 34(2.4) 29(2.9) 0.438 EnPGN 35(2.5) 28(2.8) 0.605 SGN 15(1.1) 8(0.8) 0.525 MPGN 13(0.9) 5(0.5) 0.243 FPGN 3(0.2) 3(0.3) 0.985 C1qN 1(0.1) 4(0.4) 0.192 CreGN 3(0.2) 2(0.2) 1.000 Secondary glomerulonephritis 312(21.1) 336(33.9) 0.000 HSPN 252(17.9) 182(18.3) 0.760 LN 34(2.4) 139(14.0) 0.000 HBV-GN 23(1.6) 12(1.2) 0.397 ANCA-GN 3(0.2) 3(0.3) 0.985 Hereditary glomerulonephritis 26(1.8) 17(1.7) 0.814 Alport 19(1.3) 10(1.0) 0.454 TBMN 7(0.5) 7(0.7) 0.506 Values are numbers (percentage). Alport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy; The Relationship Between Glomerular Diseases And Age As shown in Table 3 , in primary glomerular diseases, the frequencies of MCD, MN, IgMN and endocapillary proliferative glomerulonephritis (EnPGN) in the 13-18-year-old group were significantly higher than those in the 0-12-year-old group, while the frequencies of IgAN, mesangial proliferative glomerulonephritis (MsPGN) and focal proliferative glomerulonephritis (FPGN) were lower than those in the 0-12-year-old group. There was no significant difference between the two age groups in secondary glomerulonephritis. The ratio of Alport syndrome and TBMN in the 0-12-year-old group was significantly higher than that in the 13-18-year-old group. Table 3 Relationship between glomerular diseases and age Pathological classification 0-12 year 13-18 year P Value Primary glomerulonephritis 497(70.2) 1215(71.7) 0.464 IgAN 227(32.1) 356(21.0) 0.000 MCD 83(11.7) 285(16.8) 0.002 MN 50(7.1) 265(15.6) 0.000 GML 28(4.0) 64(3.8) 0.835 MsPGN 41(5.8) 50(2.9) 0.001 IgMN 13(1.8) 67(4.0) 0.008 FSGS 24(3.4) 39(2.3) 0.128 EnPGN 11(1.6) 52(3.1) 0.034 SGN 6(0.8) 17(1.0) 0.721 MPGN 6(0.8) 12(0.7) 0.718 FPGN 5(0.7) 1(0.1) 0.014 C1qN 2(0.3) 3(0.2) 0.979 CreGN 1(0.1) 4(0.2) 1.000 Secondary glomerulonephritis 177(25.0) 471(27.8) 0.160 HSPN 117(16.5) 317(18.7) 0.206 LN 51(7.2) 122(7.2) 0.996 HBV-GN 7(1.0) 28(1.7) 0.216 ANCA-GN 2(0.3) 4(0.2) 1.000 Hereditary glomerulonephritis 34(4.8) 9(0.5) 0.000 Alport 23(3.2) 6(0.4) 0.000 TBMN 11(1.6) 3(0.2) 0.000 Values are numbers (percentage). Alport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy; Changes Of Spectrum In Glomerulonephritis As shown in Table 4 , the number of renal biopsies in 2010-2019 was higher than that in 1999-2009. In primary glomerular diseases, the proportion of patients with MCD and MN in 2010-2019 was significantly higher than that in 1999-2009, while the ratios of IgAN, MsPGN, IgMN, EnPGN and membranoproliferative glomerulonephritis (MPGN) decreased. In secondary glomerular diseases, the frequencies of HSPN and HBV-associated glomerulonephritis (HBV-GN) in 2010-2019 were lower than those in 1999-2009. There was no difference in the proportions of patients with Alport syndrome and TBMN between the two groups. Table 4 Changes of spectrum in glomerulonephritis Pathological classification 1999-2009 2009-2019 P Value Primary glomerulonephritis 735(69.7) 977(72.5) 0.131 IgAN 299(28.3) 284(21.1) 0.000 MCD 142(13.5) 226(16.8) 0.026 MN 64(6.1) 251(18.6) 0.000 GML 42(4.0) 50(3.7) 0.730 MsPGN 48(4.5) 43(3.2) 0.083 IgMN 48(4.5) 32(2.4) 0.003 FSGS 28(2.7) 35(2.6) 0.930 EnPGN 36(3.4) 27(2.0) 0.032 SGN 10(0.9) 13(1.0) 0.967 MPGN 14(1.3) 4(0.3) 0.004 FPGN 2(0.2) 4(0.3) 0.912 C1qN 0(0.0) 5(0.4) 0.126 CreGN 2(0.2) 3(0.2) 1.000 Secondary glomerulonephritis 305(28.9) 343(25.4) 0.058 HSPN 217(20.6) 217 (16.1) 0.005 LN 65(6.2) 108(8.0) 0.082 HBV-GN 22(2.1) 13(1.0) 0.023 ANCA-GN 1(0.1) 5(0.4) 0.350 Hereditary glomerulonephritis 15(1.4) 28(2.1) 0.229 Alport 10(0.9) 19(1.4) 0.304 TBMN 5(0.5) 9(0.7) 0.536 Values are numbers (percentage). Alport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy; Clinicopathologic Correlation Of Pediatric Glomerular Diseases As shown in Table 5 , the constituent ratio of renal pathology corresponding to different clinical types was different. MCD (28.5%) was the most common cause of NS, followed by MN (23.7%), IgAN (14.8%) and LN (9.6%). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more frequent than other glomerular diseases. The common causes of proteinuria were glomerular minor lesion (GML) (25.4%), MN (16.4%), focal segmental glomerulosclerosis (FSGS) (14.9%), and IgAN (10.4%). GML (50.0%), IgAN (15.9%), Alport syndrome (11.4%), MsPGN (10.2%) and TBMN (8.0%) were more common in children with haematuria. IgAN (39.4%) was the most common cause of AKI, followed by MCD (21.2%), LN (10.6%) and FSGS (6.7%). Sclerosing glomerulonephritis (SGN) (21.1%) was the main cause of progressive CKD, followed by IgAN (15.8%), Alport syndrome (15.8%) and IgMN (10.5%) . Table 5 Clinicopathologic correlation of pediatric glomerular Diseases Pathological type Clinical classification Nephrotic syndrome (n=1204) Haematuria and proteinuria (n=921) AKI (n=104) Haematuria (n=88) Proteinuria (n=67) Progressive CKD (n=19) IgAN(n=583) 178(14.8) 340(36.9) 41(39.4) 14(15.9) 7(10.4) 3(15.8) MCD(n=368) 343(28.5) 2(0.2) 22(21.2) 0 1(1.5) 0 MN(n=315) 285(23.7) 19(2.1) 0 0 11(16.4) 0 GML(n=92) 4(0.3) 25(2.7) 1(1.0) 44(50.0) 17(25.4) 1(5.3) MsPGN(n=91) 36(3.0) 41(4.5) 4(3.8) 9(10.2) 1(1.5) 0 IgMN(n=80) 71(5.9) 2(0.2) 3(2.9) 0 2(3.0) 2(10.5) FSGS(n=63) 44(3.7) 1(0.1) 7(6.7) 0 10(14.9) 1(5.3) EnPGN(n=63) 17(1.4) 42(4.6) 3(2.9) 1(1.1) 0 0 SGN(n=23) 5(0.4) 11(1.2) 0 1(1.1) 2(3.0) 4(21.1) MPGN(n=18) 9(0.7) 7(0.8) 1(1.0) 0 0 1(5.3) FPGN(n=6) 1(0.1) 4(0.4) 0 0 1(1.5) 0 C1qN(n=5) 4(0.3) 1(0.1) 0 0 0 0 CreGN(n=5) 0 0 4(3.8) 0 0 1(5.3) HSPN(n=434) 63(5.2) 357(38.8) 5(4.8) 2(2.3) 6(9.0) 1(5.3) LN(n=173) 115(9.6) 44(4.8) 11(10.6) 0 2(3.0) 1(5.3) HBV-GN(n=35) 25(2.1) 6(0.7) 0 0 4(6.0) 0 ANCA-GN(n=6) 0 3(0.3) 2(1.9) 0 0 1(5.3) Alport(n=29) 4(0.3) 11(1.2) 0 10(11.4) 1(1.5) 3(15.8) TBMN(n=14) 0 5(0.5) 0 7(8.0) 2(3.0) 0 Values are numbers(percentage). Alport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy; Discussion In our study, we found that the ratio of boys to girls with glomerular disease was 1.4:1, which was roughly the same as the sex ratio of children with glomerular diseases reported earlier [ 10 – 12 ]. Boys were more likely to have IgAN and MCD than girls, which accounted for a larger proportion of glomerular diseases. The glomerular diseases confirmed by biopsies varied with age and sex. In 1999-2019, the spectrum of glomerular disease in children changed. Of the 2403 patients in this study, 1712 (71.2%) patients were diagnosed with primary glomerular diseases, 648 (27.0%) patients with secondary glomerular diseases, and 43 (1.8%) patients with hereditary glomerular diseases. The proportion of primary glomerular disease and secondary glomerular disease was roughly the same as that of children's glomerular disease previously reported [ 12 – 14 ], but the proportion of hereditary kidney disease was lower. Arapović showed that Alport syndrome accounted for 11.1% of glomerular diseases in children [ 10 ]. This difference may be due to different regions and races, because these diseases are caused by genetic abnormalities. According to renal biopsy, IgAN (24.3%) was the most common primary glomerular disease, followed by MCD (15.3%), MN (13.1%), and FSGS (2.6%). The most common primary glomerular disease in children is MCD. Since most cases of MCD can be diagnosed clinically without renal biopsy, IgAN is the most common glomerular disease diagnosed by renal biopsy. IgAN is also the most common chronic glomerular disease in the world [ 15 ]. In a single-center study in China, IgAN was identified as the most common glomerular disease in children [ 16 ]. In a cross-sectional study in China, MCD was considered to be the most common glomerular disease in children [ 12 ]. In Egypt and South Asia, MCD was reported to be the most common glomerular disease in children [ 11 , 17 , 18 ]. In Croatia and Italy, IgAN was reported to be the most common glomerular disease in children [ 10 , 14 ]. In Serbia and the United States, FSGS was reported to be the most common primary glomerular disease in children [ 19 , 20 ]. The change in glomerular disease spectrum in children from different countries may be due to the different indications for renal biopsy and race. HSPN (18.1%) was the most common secondary glomerular disease. LN is the most common secondary glomerular disease in children in South Asia [ 11 ]. HSPN is more frequecnt in children, while LN is more frequent in adults [ 21 ]. Chidren are more likely to suffer from HSPN than adults. It is worth noting that, in this study, the proportion of MN in glomerular diseases increased from 6.1–18.6%, which was much higher than that of children in other countries [ 11 , 17 , 19 , 20 ] and higher than that reported by Nie et al., which showed that the proportion of children with membranous nephropathy in China increased from 3–7% [ 12 ]. The number of patients with MN in the United States has been decreasing year by year [ 20 ]. Idiopathic membranous nephropathy is one of the most common causes of adult NS. In China, MN (43.3%) has become the most common primary glomerular disease, as opposed to IgAN. The prevalence of idiopathic MN in China has increased significantly, especially in young patients in the early stage [ 22 ]. Some studies have found that the frequency of MN is associated with long-term exposure to high levels of PM2.5 in the air [ 23 ]. The highest proportion of MN in our study may be because our region has the highest level of PM2.5 in the air. In the past 10 years, the incidence of HBV-GN and EnPGN has decreased significantly, which may be due to the widespread use of hepatitis B vaccines in China and timely antibiotic treatment for pharyngitis. Our study found that boys were more likely to suffer from MCD and IgAN, while girls were more likely to suffer from LN, which was consistent with previous reports [ 12 , 20 ]. This sex difference may be due to differences in chromosome and sex hormone levels [ 24 ]. For example, many genes carried on the X chromosome, such as those encoding FoxP3 and the Toll-like receptors TLR7 and TLR8, are associated with the pathogenesis of autoimmune diseases [ 26 ], which may play a very important role in the pathogenesis of systemic lupus erythematosus (SLE). MCD (28.5%) was the most common cause of NS. The common cause of haematuria was GML (50.0%), followed by IgAN (15.9%). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more common than other glomerular diseases. Patients with simple microscopic haematuria can be followed up. If there is proteinuria or gross haematuria, renal biopsy is recommended. Conclusions Glomerular diseases in children were related to sex and age. From 1999 to 2019, the spectrum of children's kidney disease in our center changed significantly. This study described the prevalence of renal biopsy in children in central China and provided a reference for a better understanding and prevention of kidney diseases. Abbreviations CKD Chronic kidney disease CAKUT congenital anomalies of the kidney and urinary tract ESRD end stage renal disease AKI acute kidney injury eGFR estimated glomerular filtration rate Alport Alport syndrome ANCA-GN ANCA associated glomerulonephritis CreGN crescentic glomerulonephritis C1qN C1q nephropathy EnPGN endocapillary proliferative glomerulonephritis FPGN focal proliferative glomerulonephritis FSGS focal segmental glomerulosclerosis GML glomerular minor lesion HBV-GN HBV associated glomerulonephritis HSPN Henoch-Schonlein nephritis IgAN IgA nephropathy IgMN IgM nephropathy LN Lupus nephritis MCD minimal change disease MN membranous glomerulonephritis MPGN membranoproliferative glomerulonephritis MsPGN mesangial proliferative glomerulonephritis SGN sclerosing glomerulonephritis TBMN thin basement membrane nephropathy SLE systemic lupus erythematosus. Declarations Ethics approval and consent to participate The research was in compliance of the declaration of Helsinki and approved by the ethics committee of the Second Hospital of Hebei Medical University. Before enrollment, written informed consent was provided by patients or their guardians. Consent for publication This manuscript is an original article that has not been previously published and will not be submitted to any other journal. All the authors have read this manuscript and agree that the work is ready for submission, and accept responsibility for the manuscript’s contents. Availability of data and materials The datasets used and analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare that they have no competing interests. Funding No funding was received for this study. Authors’ contributions Li-Jun Jiang, Zan-Hua Rong and Lin Yang formed the study concept, conducted the study, analyzed the data, interpreted the results, and drafted the manuscript. Xue Zhao made substantial contribution to the acquisition of data, and the analysis and interpretation of data. Zhi-Yan Dou contributed to the study design. All co-authors critically reviewed and revised the initial draft and approved the final version of the manuscript. Acknowledgement The authors are grateful to the participating team for their precious work. Authors’ information Li-Jun Jiang 1 , Xue Zhao 1 , Zhi-Yan Dou 1 , Zan-Hua Rong 1* , Lin Yang 2* 1 Department of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China. 2 Department of Nephrology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China. * Corresponding author (Zan-Hua Rong, e-mail: [email protected] ; Lin Yang, e-mail: [email protected] ) References Harambat J, Van Stralen KJ, Kim JJ, et al. Epidemiology of chronic kidney disease in children. Pediatr Nephro. 2012;27(3):363–73. Greenbaum LA, Warady BA, Furth SL. Current advances in chronic kidney disease in children: growth, cardiovascular, and neurocognitive risk factors. Semin Nephrol. 2009;29(4):425–34. Shroff R, Ledermann S. Long-term outcome of chronic dialysis in children. Pediatr Nephrol. 2009;24(3):463–74. Lewis MA, Shaw J, Sinha MD, et al. UK Renal Registry 12th Annual Report (December 2009): chapter 14: demography of the UK peadiatric renal replacement therapy population in 2008. Nephron Clin Pract. 2010;115 suppl 1:c279-88. Hattori S, Yosioka K, Honda M, et al. The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Pediatr Nephrol. 2002;17(6):456–61. Zhou F-D, Zhao M-H, Zou W-Z, et al. The changing spectrum of primary glomerular diseases within 15 years: A survey of 3331 patients in a single Chinese centre. Nephrol Dial Transplant. 2009;24(3): 870–6. Vachvanichsanong P, Dissaneewate P, McNeil E. Childhood chronic kidney disease in a developing country. Pediatr Nephrol. 2008;23(7):1143–7. Bhimma R, Adhikari M, Asharam K, et al. The spectrum of chronic kidney disease (stages 2–5) in KwaZulu-Natal, South Africa. Pediatr Nephrol. 2008;23(10):184–6. Miller ME, Williams JA. Chronic renal failure in Jamaican children—an update (2001–2006). West Indian Med J. 2009;58(3):231–4. Arapović A, Vukojević K, Filipović N, et al. Epidemiology of 10-year peadiatric renal biopsies in the region of southern Croatia. BMC Nephrol. 2020;21(1):65. Mohapatra A, Kakde S, Annapandian VM, et al. Spectrum of biopsy proven renal disease in South Asian children: Two decades at a tropical tertiary care centre. Nephrology (Carlton).2018;23(11):1013–22. Nie S, He W, Huang T, et al. The Spectrum of Biopsy-Proven Glomerular Diseases among Children in China: A National, Cross-Sectional Survey. Clin J Am Soc Nephrol. 2018;13(7):1047–54. Yin X-L, Zou M-S, Zhang Y, et al. Twenty-three-year review of disease patterns from renal biopsies: an experience from a pediatric renal center. J Nephrol. 2013;26(4):699–707. Santangelo L, Netti GS, Giordano P, et al. Indications and results of renal biopsy in children: a 36–year experience. World J Pediatr. 2018;14(2):127–33. Wenderfer SE, Gaut JP. Glomerular Diseases in Children. Adv Chronic Kidney Dis. 2017;24(6):364–71. Jiang M, Xiao Z, Rong L, et al. Twenty-eight-year review of childhood renal diseases from renal biopsy data: A single centre in China. Nephrology (Carlton). 2016;21(12):1003–9. Bakr A, Eid R, Sarhan A, et al. Pathological profile of biopsied Egyptian children with primary nephrotic syndrome: 15-year single center experience. J Nephrol. 2014;27(4):419–23. Okpechi IG, Ameh OI, Bello AK, et al. Epidemiology of Histologically Proven Glomerulonephritis in Africa: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(3):e0152203. Paripović D, Kostić M, Kruščić D, et al. Indications and results of renal biopsy in children: a 10-year review from a single center in Serbia. J Nephrol. 2012;25(6):1054–9. O’Shaughnessy MM, Hogan SL, Poulton CJ, et al. Temporal and Demographic Trends in Glomerular Disease Epidemiology in the Southeastern United States, 1986–2015. Clin J Am Soc Nephrol. 2017;12(4):614–23. Sui M, Ye X, Ma J, et al. Epidemiology and risk factors for chronic kidney disease in Chinese patients with biopsy-proven lupus nephritis. Intern Med J. 2015;45(11):1167–72. Tang L, Yao J, Kong X, et al. Increasing prevalence of membranous nephropathy in patients with primary glomerular diseases: A cross-sectional study in China. Nephrology (Carlton). 2017;22(2):168–73. Xu X, Wang G, Chen N, et al. Long-Term Exposure to Air Pollution and Increased Risk of Membranous Nephropathy in China. J Am Soc Nephrol. 2016;27(12):3739–46. Ding Y, He J, Guo J-P, et al. Gender differences are associated with the clinical features of systemic lupus erythematosus. Chin Med J(Engl). 2012;125(14):2477–81. Mu Q, Zhang H, Liao X, et al. Control of lupus nephritis by changes of gut microbiota. Microbiome. 2017;5(1):73. Wang J, Syrett CM, Kramer MC, et al. Unusual maintenance of X chromosome inactivation predisposes female lymphocytes for increased expression from the inactive X. Proc Natl Acad Sci USA. 2016;113(14):E2029-38. Cite Share Download PDF Status: Posted Version 2 posted You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-140880","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":70964282,"identity":"591c009a-d99e-4d43-9084-6e4f02615a84","order_by":0,"name":"Li-Jun Jiang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/klEQVRIiWNgGAWjYBACxmYQWSDBzMDAfOBA4h8bHn7+BmK0GIC0sCU++NiQJiM54wAxdhmACB5jw5kNh20MGhLwK2ZuZ3728IuBBbvB7QYzad4d53kMGA4wfviYg89hbObGMkCHGdw5kCbNe+Y2jzlzA7PkzG14/WImLQHSciPhmDQP220ey4YDbMy8eLWwf4NqSWwDajnHY3AggZAWHjPJD2AtycyGM9sOEKWlTBoUyJI30hgffDiTzCM542AzXr8Y9h/fJvmjoi6Z70b+hwMJFXb2/PzNBz98xKelARjQPAwMycg2N+BWDwTyICU/GBjs8KoaBaNgFIyCkQ0AQdBOxjJ2H/QAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-5747-1116","institution":"The Second Hospital of Hebei Medical University","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Li-Jun","middleName":"","lastName":"Jiang","suffix":""},{"id":70964283,"identity":"08756c9c-4b6a-4acf-8eea-ce175587072e","order_by":1,"name":"Zan-Hua Rong","email":"","orcid":"https://orcid.org/0000-0001-8056-5009","institution":"The Second Hospital of Hebei Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zan-Hua","middleName":"","lastName":"Rong","suffix":""},{"id":70964284,"identity":"78beed2b-1b96-4d36-a80e-056968d947bb","order_by":2,"name":"Xue Zhao","email":"","orcid":"","institution":"The Second Hospital of Hebei Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Xue","middleName":"","lastName":"Zhao","suffix":""},{"id":70964285,"identity":"1740bc40-29c8-4ae5-9de8-89b48faf15cb","order_by":3,"name":"Zhi-Yan Dou","email":"","orcid":"","institution":"The Second Hospital of Hebei Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Zhi-Yan","middleName":"","lastName":"Dou","suffix":""},{"id":70964286,"identity":"4e03bfda-c15b-4880-ba07-eeeffabada23","order_by":4,"name":"Lin Yang","email":"","orcid":"","institution":"The Second Hospital of Hebei Medical University","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Lin","middleName":"","lastName":"Yang","suffix":""}],"badges":[],"createdAt":"2021-01-05 07:44:11","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.3.rs-140880/v2","doiUrl":"https://doi.org/10.21203/rs.3.rs-140880/v2","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":16614449,"identity":"ffcd0653-7c96-4f30-812f-92ba08e3f31c","added_by":"auto","created_at":"2021-12-20 15:41:01","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":48352,"visible":true,"origin":"","legend":"\u003cp\u003ePathological categories of 2403 cases of pediatric glomerular disease\u003c/p\u003e\u003cp\u003eAlport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy;\u003c/p\u003e","description":"","filename":"JiangFigure1.png","url":"https://assets-eu.researchsquare.com/files/rs-140880/v2/a499655c5f217e8be4131c70.png"},{"id":31072609,"identity":"b7efdd35-622f-427e-badc-bebd8e68efeb","added_by":"auto","created_at":"2023-01-04 08:11:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":638755,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-140880/v2/682dc3ae-7a19-4d23-93fc-d31876ca2c69.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eThe Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019\u003c/p\u003e","fulltext":[{"header":"Background","content":"\u003cp\u003eChronic kidney disease (CKD) has become one of the major diseases threatening global public health [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. It is a major chronic disease that causes a high medical burden and seriously affects quality of life. If CKD is not diagnosed and treated in time, the mortality of CKD will be significantly increased once it develops into end-stage renal disease (ESRD) [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Therefore, how to detect and treat CKD early in children is a clinical problem to be solved.\u003c/p\u003e \u003cp\u003eThe aetiology of CKD varies in different regions and ethnic groups. Congenital anomalies of the kidney and urinary tract (CAKUT) are the main causes of CKD in children in developed countries [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e], while glomerular diseases are the main causes in developing countries [\u003cspan additionalcitationids=\"CR7 CR8\" citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Glomerular disease is still the main cause of CKD in children in China [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The diagnosis and treatment of glomerular diseases mainly depend on renal biopsy. Renal biopsy is an invasive procedure with the risk of haemorrhage and arteriovenous fistula. Therefore, it is very important to study the spectrum of glomerular diseases; the relationship between renal pathology and clinical manifestations; and the relationship between glomerular diseases and age, sex and years. This will correctly diagnose glomerular disease in children without renal biopsy. In China, there are few centers that study glomerular diseases in children.\u003c/p\u003e \u003cp\u003eThis study retrospectively analysed the clinical and pathological data of 2403 renal biopsies of children in a single center; clarified the constitution, changes and distribution of kidney diseases; and analysed them according to the patient's sex and age.\u003c/p\u003e"},{"header":"Materials And Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eInclusion and exclusion criteria\u003c/h2\u003e \u003cp\u003eFrom 1999 to 2019, we selected 2453 children with kidney disease under the age of 18 who underwent renal biopsy. The exclusion criteria were pathological results of renal biopsy with less than 5 glomeruli under a light microscope, incomplete clinical data, or tubulointerstitial disease or renal vascular disease without glomerular lesions. Finally, 50 cases were excluded, and 2403 cases were included in this analysis. The patients and/or parents signed the consent form before renal biopsy. The research was in compliance of the declaration of Helsinki and approved by the ethics committee of the Second Hospital of Hebei Medical University. Before enrollment, written informed consent was provided by patients or their guardians.\u003c/p\u003e \u003c/div\u003e\n\u003ch2\u003eClinical Classification\u003c/h2\u003e\n\u003cp\u003eAccording to the clinical classification standard of children's glomerular disease formulated by the Chinese Medical Association in 2000, we divided 2403 children into six clinical types: nephrotic syndrome (NS), acute kidney injury (AKI), progressive CKD (defined as eGFR \u0026lt; 60 mL/min/1.73 m\u003csup\u003e2\u003c/sup\u003e), proteinuria, haematuria, and proteinuria with haematuria. The glomerular filtration rate was calculated by the swatch formula. NS was defined as proteinuria greater than 50 mg/kg\u0026middot;d or greater than 3.5 g/kg and serum albumin less than 30 g/L. Proteinuria that does not meet the criteria for NS is defined as proteinuria.\u003c/p\u003e\n\u003ch2\u003eIndications And Contraindications For Percutaneous Renal Biopsy\u003c/h2\u003e\n\u003cp\u003eThe indications for percutaneous renal biopsy include steroid-resistant NS, a part of steroid-dependent and frequently recurrent NS; NS with glomerular haematuria or renal insufficiency or hypertension or low complement; unexplained persistent haematuria and/or proteinuria; unknown AKI or unexplained progressive CKD; nephrotic proteinuria or NS or gross haematuria or AKI caused by Henoch-Schonlein purpura nephritis (HSPN); and other secondary glomerulonephritides. The contraindications for renal puncture include an isolated kidney, displaced kidney, abnormal renal structure, coagulation disorder, ESRD and renal infection.\u003c/p\u003e\n\u003ch2\u003ePathological Examination\u003c/h2\u003e\n\u003cp\u003eAll pathological tissues were examined by light microscopy and immunofluorescence, and approximately 50% of them were further examined by electron microscopy.\u003c/p\u003e\n\u003ch2\u003eGrouping\u003c/h2\u003e\n\u003cp\u003eAccording to age, they were divided into two groups: 0-12 years old and 13-18 years old. According to the time of renal puncture, they were divided into two groups: 1999-2009 and 2010-2019. According to sex, they were divided into male and female groups. According to the clinical classification of children's kidney disease, they were divided into 6 groups: NS, AKI, progressive CKD, proteinuria, haematuria and proteinuria with haematuria. The constituent ratios of renal pathology in different sexes, ages and years were compared. The constituent ratio of renal pathology corresponding to different clinical types was compared.\u003c/p\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eData were expressed as the mean \u0026plusmn; SD. The chi- square test was used to analyse the constituent ratio. SPSS 23.0 software was used for statistical analysis. A P value of \u003cb\u003e\u0026le;\u003c/b\u003e 0.05 was considered to be statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eGeneral information\u003c/h2\u003e \u003cp\u003eA total of 2403 renal biopsy specimens were analysed from 1999 to 2019, including 1411 males and 992 females, with a male to female ratio of 1.4:1. The average age at renal biopsy was 13.5 \u0026plusmn; 3.4 years old. The youngest was 1 month, 708 cases (29.5%) were 0-12 years old, and 1695 cases (70.5%) were 13-18 years old. From 1999 to 2009, 1055 patients (43.9%) underwent renal biopsy, and 1348 patients (56.1%) underwent renal biopsy from 2010 to 2019. The most common clinical syndrome was NS (50.1%), followed by haematuria and proteinuria (38.3%) (Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDemographic and clinical characteristics of 2403 children who underwent kidney biopsy 1999 to 2019\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eCharacteristics\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eTotal,n=2403\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eSex\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMale,n=1411\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFemale,n=992\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eClinical syndrome,n(%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNephrotic syndrome\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1204(50.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e665(47.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e539(54.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaematuria and proteinuria\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e921(38.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e561(39.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e360(36.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAKI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e104(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68(4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36(3.6)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaematuria\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e88(3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e56(4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32(3.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProteinuria\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e67(2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e47(3.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20(2.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eProgressive CKD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5(0.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge,yr,mean(SD)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13.5(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13.5(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e13.5(3.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0-12,n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e708(29.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e402(28.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e306(30.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e13-18,n(%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1695(70.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1009(71.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e686(69.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTime of kidney biopsy,n(%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1999-2009\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1055(43.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e665(47.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e390(39.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2010-2019\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1348(56.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e746(52.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e602(60.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are numbers(percentage).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn this study, 1712 (71.2%) patients were diagnosed with primary glomerular disease, 648 (27.0%) patients were diagnosed with secondary glomerular disease, and 43 (1.8%) patients were diagnosed with hereditary glomerular disease. The most common primary glomerular disease was IgA nephropathy (IgAN) (24.3%), followed by minimal change disease (MCD) (15.3%) and membranous glomerulonephritis (MN) (13.1%). HSPN (18.1%) and lupus nephritis (LN) (7.2%) were more frequent in secondary glomerular diseases. Alport syndrome and thin basement membrane nephropathy (TBMN) were the most common inherited glomerular diseases, accounting for 1.2% and 0.6% of the total glomerular diseases in children, respectively (Figure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e\n\u003ch2\u003eThe Relationship Between Glomerular Diseases And Sex\u003c/h2\u003e\n\u003cp\u003eAs described in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the number of boys with IgAN, MCD and IgM nephropathy (IgMN) was significantly higher than that of girls, while the number of girls with MN was significantly higher than that of boys. In secondary glomerular diseases, the number of girls with LN was significantly higher than that of boys, and there was no significant difference in the proportion of HSPN between the two groups. There was also no significant difference in the proportions of Alport syndrome and TBMN between the two groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRelationship between glomerular diseases and sex\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathological classification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrimary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1073(76.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e639(64.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgAN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e382(27.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e201(20.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e259(18.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e109(11.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e156(11.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e159(16.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGML\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e58(4.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e34(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.390\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMsPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e53(3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e38(3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.925\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e61(4.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19(1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFSGS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34(2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29(2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.438\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35(2.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28(2.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.605\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.525\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.243\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC1qN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.192\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecondary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e312(21.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e336(33.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHSPN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e252(17.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e182(18.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.760\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34(2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e139(14.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHBV-GN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23(1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.397\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANCA-GN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.985\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHereditary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26(1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17(1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.814\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlport\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.454\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.506\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are numbers (percentage).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eAlport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch2\u003eThe Relationship Between Glomerular Diseases And Age\u003c/h2\u003e\n\u003cp\u003eAs shown in Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, in primary glomerular diseases, the frequencies of MCD, MN, IgMN and endocapillary proliferative glomerulonephritis (EnPGN) in the 13-18-year-old group were significantly higher than those in the 0-12-year-old group, while the frequencies of IgAN, mesangial proliferative glomerulonephritis (MsPGN) and focal proliferative glomerulonephritis (FPGN) were lower than those in the 0-12-year-old group. There was no significant difference between the two age groups in secondary glomerulonephritis. The ratio of Alport syndrome and TBMN in the 0-12-year-old group was significantly higher than that in the 13-18-year-old group.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRelationship between glomerular diseases and age\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathological classification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0-12 year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13-18 year\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrimary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e497(70.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1215(71.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.464\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgAN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e227(32.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e356(21.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e83(11.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e285(16.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50(7.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e265(15.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGML\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28(4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64(3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.835\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMsPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e41(5.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50(2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e13(1.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e67(4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.008\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFSGS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e24(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e39(2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.128\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11(1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52(3.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.721\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.718\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.014\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC1qN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.979\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecondary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e177(25.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e471(27.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.160\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHSPN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e117(16.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e317(18.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.206\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51(7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e122(7.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.996\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHBV-GN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28(1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.216\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANCA-GN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHereditary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e34(4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlport\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e23(3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e11(1.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are numbers (percentage).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eAlport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch2\u003eChanges Of Spectrum In Glomerulonephritis\u003c/h2\u003e\n\u003cp\u003eAs shown in Table \u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, the number of renal biopsies in 2010-2019 was higher than that in 1999-2009. In primary glomerular diseases, the proportion of patients with MCD and MN in 2010-2019 was significantly higher than that in 1999-2009, while the ratios of IgAN, MsPGN, IgMN, EnPGN and membranoproliferative glomerulonephritis (MPGN) decreased. In secondary glomerular diseases, the frequencies of HSPN and HBV-associated glomerulonephritis (HBV-GN) in 2010-2019 were lower than those in 1999-2009. There was no difference in the proportions of patients with Alport syndrome and TBMN between the two groups.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eChanges of spectrum in glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePathological classification\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1999-2009\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2009-2019\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eP Value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePrimary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e735(69.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e977(72.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.131\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgAN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e299(28.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e284(21.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e142(13.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e226(16.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.026\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e64(6.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e251(18.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGML\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42(4.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50(3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.730\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMsPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48(4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e43(3.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.083\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e48(4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e32(2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.003\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFSGS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e28(2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e35(2.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.930\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36(3.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e27(2.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.032\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.967\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e14(1.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFPGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.912\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC1qN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0(0.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.126\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreGN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSecondary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e305(28.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e343(25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.058\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHSPN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e217(20.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e217 (16.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.005\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e65(6.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e108(8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.082\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHBV-GN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e13(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.023\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANCA-GN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.350\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHereditary glomerulonephritis\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15(1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.229\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlport\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e10(0.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19(1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.304\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBMN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.536\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eValues are numbers (percentage).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"4\"\u003eAlport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\n\u003ch2\u003eClinicopathologic Correlation Of Pediatric Glomerular Diseases\u003c/h2\u003e\n\u003cp\u003eAs shown in Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e, the constituent ratio of renal pathology corresponding to different clinical types was different. MCD (28.5%) was the most common cause of NS, followed by MN (23.7%), IgAN (14.8%) and LN (9.6%). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more frequent than other glomerular diseases. The common causes of proteinuria were glomerular minor lesion (GML) (25.4%), MN (16.4%), focal segmental glomerulosclerosis (FSGS) (14.9%), and IgAN (10.4%). GML (50.0%), IgAN (15.9%), Alport syndrome (11.4%), MsPGN (10.2%) and TBMN (8.0%) were more common in children with haematuria. IgAN (39.4%) was the most common cause of AKI, followed by MCD (21.2%), LN (10.6%) and FSGS (6.7%). Sclerosing glomerulonephritis (SGN) (21.1%) was the main cause of progressive CKD, followed by IgAN (15.8%), Alport syndrome (15.8%) and IgMN (10.5%) .\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClinicopathologic correlation of pediatric glomerular Diseases\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003ePathological type\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eClinical classification\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNephrotic syndrome\u003c/p\u003e \u003cp\u003e(n=1204)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHaematuria and proteinuria\u003c/p\u003e \u003cp\u003e(n=921)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eAKI\u003c/p\u003e \u003cp\u003e(n=104)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHaematuria\u003c/p\u003e \u003cp\u003e(n=88)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eProteinuria\u003c/p\u003e \u003cp\u003e(n=67)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eProgressive CKD\u003c/p\u003e \u003cp\u003e(n=19)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgAN(n=583)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e178(14.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e340(36.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41(39.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14(15.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7(10.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3(15.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMCD(n=368)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e343(28.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22(21.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMN(n=315)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e285(23.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11(16.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGML(n=92)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25(2.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44(50.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17(25.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMsPGN(n=91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e36(3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41(4.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9(10.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIgMN(n=80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71(5.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2(0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2(10.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFSGS(n=63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e44(3.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7(6.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10(14.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEnPGN(n=63)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17(1.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42(4.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3(2.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSGN(n=23)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1(1.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4(21.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMPGN(n=18)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7(0.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1(1.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFPGN(n=6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4(0.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC1qN(n=5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1(0.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreGN(n=5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4(3.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHSPN(n=434)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63(5.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e357(38.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5(4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2(2.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6(9.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLN(n=173)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e115(9.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44(4.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11(10.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHBV-GN(n=35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e25(2.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6(0.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4(6.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANCA-GN(n=6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2(1.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1(5.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlport(n=29)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4(0.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11(1.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10(11.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1(1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e3(15.8)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTBMN(n=14)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5(0.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7(8.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2(3.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eValues are numbers(percentage).\u003c/td\u003e\u003c/tr\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eAlport: Alport syndrome; ANCA-GN: ANCA-associated glomerulonephritis; CreGN: crescentic glomerulonephritis; C1qN: C1q nephropathy; EnPGN: endocapillary proliferative glomerulonephritis; FPGN: focal proliferative glomerulonephritis; FSGS: focal segmental glomerulosclerosis; GML: glomerular minor lesion; HBV-GN: HBV-associated glomerulonephritis; HSPN: Henoch-Schonlein nephritis; IgAN: IgA nephropathy; IgMN: IgM nephropathy; LN: Lupus nephritis; MCD: minimal change disease; MN: membranous glomerulonephritis; MPGN: membranoproliferative glomerulonephritis; MsPGN: mesangial proliferative glomerulonephritis; SGN: sclerosing glomerulonephritis; TBMN: thin basement membrane nephropathy;\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn our study, we found that the ratio of boys to girls with glomerular disease was 1.4:1, which was roughly the same as the sex ratio of children with glomerular diseases reported earlier [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Boys were more likely to have IgAN and MCD than girls, which accounted for a larger proportion of glomerular diseases. The glomerular diseases confirmed by biopsies varied with age and sex. In 1999-2019, the spectrum of glomerular disease in children changed.\u003c/p\u003e \u003cp\u003eOf the 2403 patients in this study, 1712 (71.2%) patients were diagnosed with primary glomerular diseases, 648 (27.0%) patients with secondary glomerular diseases, and 43 (1.8%) patients with hereditary glomerular diseases. The proportion of primary glomerular disease and secondary glomerular disease was roughly the same as that of children's glomerular disease previously reported [\u003cspan additionalcitationids=\"CR13\" citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e], but the proportion of hereditary kidney disease was lower. Arapović showed that Alport syndrome accounted for 11.1% of glomerular diseases in children [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. This difference may be due to different regions and races, because these diseases are caused by genetic abnormalities.\u003c/p\u003e \u003cp\u003eAccording to renal biopsy, IgAN (24.3%) was the most common primary glomerular disease, followed by MCD (15.3%), MN (13.1%), and FSGS (2.6%). The most common primary glomerular disease in children is MCD. Since most cases of MCD can be diagnosed clinically without renal biopsy, IgAN is the most common glomerular disease diagnosed by renal biopsy. IgAN is also the most common chronic glomerular disease in the world [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. In a single-center study in China, IgAN was identified as the most common glomerular disease in children [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. In a cross-sectional study in China, MCD was considered to be the most common glomerular disease in children [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In Egypt and South Asia, MCD was reported to be the most common glomerular disease in children [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. In Croatia and Italy, IgAN was reported to be the most common glomerular disease in children [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In Serbia and the United States, FSGS was reported to be the most common primary glomerular disease in children [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The change in glomerular disease spectrum in children from different countries may be due to the different indications for renal biopsy and race.\u003c/p\u003e \u003cp\u003eHSPN (18.1%) was the most common secondary glomerular disease. LN is the most common secondary glomerular disease in children in South Asia [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. HSPN is more frequecnt in children, while LN is more frequent in adults [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Chidren are more likely to suffer from HSPN than adults.\u003c/p\u003e \u003cp\u003eIt is worth noting that, in this study, the proportion of MN in glomerular diseases increased from 6.1\u0026ndash;18.6%, which was much higher than that of children in other countries [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] and higher than that reported by Nie et al., which showed that the proportion of children with membranous nephropathy in China increased from 3\u0026ndash;7% [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. The number of patients with MN in the United States has been decreasing year by year [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Idiopathic membranous nephropathy is one of the most common causes of adult NS. In China, MN (43.3%) has become the most common primary glomerular disease, as opposed to IgAN. The prevalence of idiopathic MN in China has increased significantly, especially in young patients in the early stage [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Some studies have found that the frequency of MN is associated with long-term exposure to high levels of PM2.5 in the air [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The highest proportion of MN in our study may be because our region has the highest level of PM2.5 in the air. In the past 10 years, the incidence of HBV-GN and EnPGN has decreased significantly, which may be due to the widespread use of hepatitis B vaccines in China and timely antibiotic treatment for pharyngitis.\u003c/p\u003e \u003cp\u003eOur study found that boys were more likely to suffer from MCD and IgAN, while girls were more likely to suffer from LN, which was consistent with previous reports [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. This sex difference may be due to differences in chromosome and sex hormone levels [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. For example, many genes carried on the X chromosome, such as those encoding FoxP3 and the Toll-like receptors TLR7 and TLR8, are associated with the pathogenesis of autoimmune diseases [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e], which may play a very important role in the pathogenesis of systemic lupus erythematosus (SLE).\u003c/p\u003e \u003cp\u003eMCD (28.5%) was the most common cause of NS. The common cause of haematuria was GML (50.0%), followed by IgAN (15.9%). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more common than other glomerular diseases. Patients with simple microscopic haematuria can be followed up. If there is proteinuria or gross haematuria, renal biopsy is recommended.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eGlomerular diseases in children were related to sex and age. From 1999 to 2019, the spectrum of children's kidney disease in our center changed significantly. This study described the prevalence of renal biopsy in children in central China and provided a reference for a better understanding and prevention of kidney diseases.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cdiv class=\"DefinitionList\"\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCKD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eChronic kidney disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCAKUT\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003econgenital anomalies of the kidney and urinary tract\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eESRD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eend stage renal disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAKI\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eacute kidney injury\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eeGFR\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eestimated glomerular filtration rate\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eAlport\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eAlport syndrome\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eANCA-GN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eANCA associated glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eCreGN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ecrescentic glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eC1qN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eC1q nephropathy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eEnPGN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eendocapillary proliferative glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFPGN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003efocal proliferative glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eFSGS\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003efocal segmental glomerulosclerosis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eGML\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eglomerular minor lesion\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHBV-GN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHBV associated glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eHSPN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eHenoch-Schonlein nephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIgAN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIgA nephropathy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eIgMN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eIgM nephropathy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eLN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eLupus nephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMCD\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003eminimal change disease\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emembranous glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMPGN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emembranoproliferative glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eMsPGN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003emesangial proliferative glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSGN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esclerosing glomerulonephritis\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eTBMN\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003ethin basement membrane nephropathy\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv class=\"DefinitionListEntry\"\u003e \u003cdiv class=\"Term\"\u003eSLE\u003c/div\u003e \u003cdiv class=\"Description\"\u003e \u003cp\u003esystemic lupus erythematosus.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe research was in compliance of the declaration of Helsinki and approved by the ethics committee of the Second Hospital of Hebei Medical University. Before enrollment, written informed consent was provided by patients or their guardians.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis manuscript is an original article that has not been previously published and will not be submitted to any other journal. All the authors have read this manuscript and agree that the work is ready for submission, and accept responsibility for the manuscript\u0026rsquo;s contents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was received for this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLi-Jun Jiang, Zan-Hua Rong and Lin Yang formed the study concept, conducted the study, analyzed the data, interpreted the results, and drafted the manuscript. Xue Zhao made substantial contribution to the acquisition of data, and the analysis and interpretation of data. Zhi-Yan Dou contributed to the study design. All co-authors critically reviewed and revised the initial draft and approved the final version of the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors are grateful to the participating team for their precious work.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLi-Jun Jiang\u003csup\u003e1\u003c/sup\u003e, Xue Zhao\u003csup\u003e1\u003c/sup\u003e, Zhi-Yan Dou\u003csup\u003e1\u003c/sup\u003e, Zan-Hua Rong\u003csup\u003e1*\u003c/sup\u003e, Lin Yang\u003csup\u003e2*\u003c/sup\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e1\u003c/sup\u003eDepartment of Pediatrics, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e2\u003c/sup\u003eDepartment of Nephrology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China.\u003c/p\u003e\n\u003cp\u003e\u003csup\u003e*\u003c/sup\u003eCorresponding author (Zan-Hua Rong, e-mail:\u0026nbsp;\u003ca href=\"mailto:[email protected]\"\[email protected]\u003c/a\u003e; Lin Yang, e-mail: [email protected])\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHarambat J, Van Stralen KJ, Kim JJ, et al. Epidemiology of chronic kidney disease in children. Pediatr Nephro. 2012;27(3):363\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGreenbaum LA, Warady BA, Furth SL. Current advances in chronic kidney disease in children: growth, cardiovascular, and neurocognitive risk factors. Semin Nephrol. 2009;29(4):425\u0026ndash;34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShroff R, Ledermann S. Long-term outcome of chronic dialysis in children. Pediatr Nephrol. 2009;24(3):463\u0026ndash;74.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLewis MA, Shaw J, Sinha MD, et al. UK Renal Registry 12th Annual Report (December 2009): chapter 14: demography of the UK peadiatric renal replacement therapy population in 2008. Nephron Clin Pract. 2010;115 suppl 1:c279-88.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHattori S, Yosioka K, Honda M, et al. The 1998 report of the Japanese National Registry data on pediatric end-stage renal disease patients. Pediatr Nephrol. 2002;17(6):456\u0026ndash;61.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhou F-D, Zhao M-H, Zou W-Z, et al. The changing spectrum of primary glomerular diseases within 15 years: A survey of 3331 patients in a single Chinese centre. Nephrol Dial Transplant. 2009;24(3): 870\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eVachvanichsanong P, Dissaneewate P, McNeil E. Childhood chronic kidney disease in a developing country. Pediatr Nephrol. 2008;23(7):1143\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhimma R, Adhikari M, Asharam K, et al. The spectrum of chronic kidney disease (stages 2\u0026ndash;5) in KwaZulu-Natal, South Africa. Pediatr Nephrol. 2008;23(10):184\u0026ndash;6.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMiller ME, Williams JA. Chronic renal failure in Jamaican children\u0026mdash;an update (2001\u0026ndash;2006). West Indian Med J. 2009;58(3):231\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArapović A, Vukojević K, Filipović N, et al. Epidemiology of 10-year peadiatric renal biopsies in the region of southern Croatia. BMC Nephrol. 2020;21(1):65.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMohapatra A, Kakde S, Annapandian VM, et al. Spectrum of biopsy proven renal disease in South Asian children: Two decades at a tropical tertiary care centre. Nephrology (Carlton).2018;23(11):1013\u0026ndash;22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNie S, He W, Huang T, et al. The Spectrum of Biopsy-Proven Glomerular Diseases among Children in China: A National, Cross-Sectional Survey. Clin J Am Soc Nephrol. 2018;13(7):1047\u0026ndash;54.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYin X-L, Zou M-S, Zhang Y, et al. Twenty-three-year review of disease patterns from renal biopsies: an experience from a pediatric renal center. J Nephrol. 2013;26(4):699\u0026ndash;707.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSantangelo L, Netti GS, Giordano P, et al. Indications and results of renal biopsy in children: a 36\u0026ndash;year experience. World J Pediatr. 2018;14(2):127\u0026ndash;33.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWenderfer SE, Gaut JP. Glomerular Diseases in Children. Adv Chronic Kidney Dis. 2017;24(6):364\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJiang M, Xiao Z, Rong L, et al. Twenty-eight-year review of childhood renal diseases from renal biopsy data: A single centre in China. Nephrology (Carlton). 2016;21(12):1003\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBakr A, Eid R, Sarhan A, et al. Pathological profile of biopsied Egyptian children with primary nephrotic syndrome: 15-year single center experience. J Nephrol. 2014;27(4):419\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOkpechi IG, Ameh OI, Bello AK, et al. Epidemiology of Histologically Proven Glomerulonephritis in Africa: A Systematic Review and Meta-Analysis. PLoS One. 2016;11(3):e0152203.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eParipović D, Kostić M, Kruščić D, et al. Indications and results of renal biopsy in children: a 10-year review from a single center in Serbia. J Nephrol. 2012;25(6):1054\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eO\u0026rsquo;Shaughnessy MM, Hogan SL, Poulton CJ, et al. Temporal and Demographic Trends in Glomerular Disease Epidemiology in the Southeastern United States, 1986\u0026ndash;2015. Clin J Am Soc Nephrol. 2017;12(4):614\u0026ndash;23.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSui M, Ye X, Ma J, et al. Epidemiology and risk factors for chronic kidney disease in Chinese patients with biopsy-proven lupus nephritis. Intern Med J. 2015;45(11):1167\u0026ndash;72.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTang L, Yao J, Kong X, et al. Increasing prevalence of membranous nephropathy in patients with primary glomerular diseases: A cross-sectional study in China. Nephrology (Carlton). 2017;22(2):168\u0026ndash;73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eXu X, Wang G, Chen N, et al. Long-Term Exposure to Air Pollution and Increased Risk of Membranous Nephropathy in China. J Am Soc Nephrol. 2016;27(12):3739\u0026ndash;46.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDing Y, He J, Guo J-P, et al. Gender differences are associated with the clinical features of systemic lupus erythematosus. Chin Med J(Engl). 2012;125(14):2477\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMu Q, Zhang H, Liao X, et al. Control of lupus nephritis by changes of gut microbiota. Microbiome. 2017;5(1):73.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWang J, Syrett CM, Kramer MC, et al. Unusual maintenance of X chromosome inactivation predisposes female lymphocytes for increased expression from the inactive X. Proc Natl Acad Sci USA. 2016;113(14):E2029-38.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Pediatric, Renal biopsy, Glomerular diseases","lastPublishedDoi":"10.21203/rs.3.rs-140880/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-140880/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e This study aimed to investigate the clinical and pathological characteristics and the changes in glomerular diseases in 2403 pediatric renal biopsies from 1999 to 2019.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eRenal biopsies performed on children aged ≤18 years between 1999 and 2019 were analysed at our center. We analysed the clinical and histological characteristics, distribution of pediatric glomerular diseases with various clinical presentations, and changes in the glomerular disease patterns during the study period.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThe most common primary glomerular disease was IgA nephropathy (IgAN) (24.3%), followed by minimal change disease (MCD) (15.3%) and membranous glomerulonephritis (MN) (13.1%). Henoch-Schonlein purpura nephritis (HSPN) (18.1%) and lupus nephritis (LN) (7.2%) were the most frequently recorded secondary glomerular diseases. Alport syndrome and thin basement membrane nephropathy (TBMN) were the most common inherited glomerular diseases, accounting for 1.2% and 0.6% of the total glomerular diseases in children, respectively. The number of boys with IgAN, MCD and IgM nephropathy (IgMN) was higher than that of girls, while the number of girls with MN and LN was higher than that of boys. The frequencies of MCD, MN, IgMN and endocapillary proliferative glomerulonephritis (EnPGN) in the 13-18-year-old group were higher than those in the 0-12-year-old group, while the frequencies of IgAN, mesangial proliferative glomerulonephritis (MsPGN) and focal proliferative glomerulonephritis (FPGN) were lower than those in the 0-12-year-old group. The ratio of Alport syndrome and TBMN in the 0-12-year-old group was higher than that in the 13-18-year-old group. The proportion of patients with MCD and MN in 2010-2019 was higher than that in 1999-2009, while the ratio of IgAN, MsPGN, IgMN, EnPGN, membranoproliferative glomerulonephritis (MPGN), HSPN and HBV-associated glomerulonephritis (HBV-GN) decreased. MCD (28.5%) was the most common cause of nephrotic syndrome (NS). In children with haematuria and proteinuria, HSPN (38.8%) and IgAN (36.9%) were more common than other glomerular diseases. IgAN (39.4%) was the most common cause of AKI. Sclerosing glomerulonephritis (SGN) (21.1%) was the main cause of progressive chronic kidney disease (CKD).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusions: \u003c/strong\u003eGlomerular diseases in children were related to sex and age. From 1999 to 2019, the spectrum of children's kidney disease in our center changed significantly.\u003c/p\u003e","manuscriptTitle":"The Spectrum of Children's Kidney Diseases—2403 Renal Biopsy-Proven Cases from a Single Centre in China Between 1999 and 2019","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2021-12-20 15:40:59","doi":"10.21203/rs.3.rs-140880/v2","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2021-01-18 15:37:04","doi":"10.21203/rs.3.rs-140880/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1cadddf5-19ae-423b-97ce-0a6536c9d859","owner":[],"postedDate":"December 20th, 2021","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":9275730,"name":"Pediatrics"}],"tags":[],"updatedAt":"2023-01-04T08:11:02+00:00","versionOfRecord":[],"versionCreatedAt":"2021-12-20 15:40:59","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v2","identity":"rs-140880","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-140880","identity":"rs-140880","version":["v2"]},"buildId":"cBFmMYwuxLRRLfASyISRj","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}