Changes in the Spectrum of Kidney Diseases: A 14-Year Kidney Biopsy Study from a Single Center

Background: CKD is a critical global public health concern. Early detection and treatment are crucial in preventing progression. Renal biopsy remains a cornerstone in diagnosing various kidney diseases. Recent decades have seen shifts in the disease spectrum, driven by factors like hepatitis B, diabetes, and aging. The study aims to investigate the changing spectrum of kidney diseases for disease prevention and public health interventions. Methods: Patients (≥14 years of age) who underwent renal biopsy at the First Affiliated Hospital of Fujian Medical University from January 2010 to December 2023 were included in the study. Clinicopathological data was collected. Results: This study involved 2832 patients. Annual renal biopsy numbers rose from 81 in 2010 to 381 in 2023 (Fig 1A). Primary glomerulonephritis (GN) was the leading cause of kidney diseases (Fig 1B). Patients aged ≥60 years grew from 9.3% in 2020 to 23.2% in 2023, showing a demographic shift towards an older population. MN, IgAN, and MCD were the most common primary GN subtypes, representing 34.9%, 34.5%, and 18.5% of cases, respectively (Fig 2A). From 2010 to 2023, MN cases increased from 14.8% to 36.0%. MN predominantly occurred in the elderly, with rising prevalence with age (Fig 2B). LN, DN, and HBVN were the top secondary GN causes, accounting for 34.3%, 24.8%, and 9.0% of cases, respectively (Fig 2C). DN notably rose from 5.6% in 2010 to 40.0% in 2018. HBVN incidence consistently declined. LN primarily affected younger patients, while DN was more prevalent in older individuals, peaking at 43.8% in the 45-59 age group (Fig 2D). Conclusion: The spectrum of kidney disease has changed within the last 14 years. The relative frequency of MN and DN increased significantly, while that of HBVN decreased significantly. Funding: Government Support – Non-U.S.