Background: Scleroderma is a rare autoimmune disease occurs with an annual rate of about 2-20 cases / 1 million people. Objectives: To evaluate the common clinical and laboratory manifestaions of scleroderma associated renal disease. Subjects and method: A restrospective study of clinical, urinary analysis, biochemical and blood count analysis and renal artery dopper ultrasonography indexes in 147 patients with scleroderma. Results: The commonest nonrenal clinical manifestations were skin thickening (100%), pigmentation (71,43%), arthalgia/ arthritis (83%), Raynaud phenomenon (62,58%) and gastroentrological syndrome (50,34%). 11,56% of patients had signs and symptoms of kidney involvement such us hypertension (10,2%), edema (9,52%), oliguria (3,4%). 14,29%, 10,88% and 18,18% of patients had abnomalities on urinary analysis, increased blood urea and renal artery stenosis on dooper ultrasonography, respectively. Conclusion: 11,56% of patients had rena manifestationsin clinical, the commonest is hypertension, edema and oliguria. 14,29%, 10,88% and 18,18% of patients had positive proteinuria of hematuria, increased blood urea and renal artery stenosis on dopper ultrasonography, respectively.
Kidney Diseases/ epidemiology ; Scleroderma ; Systemic ;

OBJECTIVETo study and analysis prevalence and incidence of target organ injury and the relative factors for isolated systolic hypertension (ISH) in Beijing.

METHODS1002 cases aged 80 to 99 years were investigated in 28 cadre retirement centers in Beijing. Blood pressure was taken for three times with mercurial sphygmomanometer in every person, the mean values were recorded and the relative material was gathered according to questionnaire after the health education. Physical examination form of outpatient department and inpatient case history in fixed hospital were analyzed.

RESULTSIn 1002 very old persons, there were 673 hypertensive patients (67.2%) and 455 ISH (45.4%). Among all hypertensive patients, the rate of ISH was 67.6% and double hypertension was 32.4%. Awareness rate was 87.90% and 97.71%, taking antihypertensive drug rate was 77.58% and 80.73%, control rate was 58.68% and 62.84% in ISH and in double hypertension group, respectively, which were no significant differences between the two groups. There was no significant difference in morbidities of cardiac heart disease, myocardial infarction and chronic renal insufficiency between the two groups. The incidences of heart failure, cerebrovascular disease, disability and dementia were 4.62% and 8.72%, 41.54% and 55.50%, 10.55% and 16.06%, 8.57% and 12.84% in ISH and double hypertension group, respectively, which were significant differences between the two groups (P < 0.01). The susceptible age period for ISH was 70 to 79 years in this study.

CONCLUSIONISH is more common in hypertensive patients in very old persons at 28 cadre retirement centers in Beijing. Morbidity of heart failure, cerebrovascular disease, disability and dementia were higher in double hypertension group compared with those in ISH group. The results showed that increase of both systolic and diastolic blood pressure was more dangerous than that of systolic pressure only for very old persons. The improvement of small arterial plastic and the control of blood pressure to target level (< 140/90 mm Hg) in very old hypertensive patients are very important for decreasing the incidence of target organ injury and increasing their life quality and late survival rate.

Aged, 80 and over ; Cardiovascular Diseases ; epidemiology ; Cerebrovascular Disorders ; epidemiology ; China ; epidemiology ; Diabetes Mellitus ; epidemiology ; Female ; Humans ; Hyperlipidemias ; epidemiology ; Hypertension ; epidemiology ; physiopathology ; Kidney Failure, Chronic ; epidemiology ; Male ; Prevalence ; Systole

INTRODUCTIONTo determine the magnitude of gender difference in paediatric hospital admissions.

MATERIALS AND METHODSWe reviewed discharge data of general medical paediatric admissions to a university teaching hospital in Hong Kong from 1984 to 2000. Based on ICD-9 codes, 9 broad categories of disease with related sub-categories were used, namely respiratory, gastrointestinal, neurological, renal, cardiac, haematological/oncological, neonatal, miscellaneous and social. Data on patients admitted to the haematological, oncological and neonatal wards were excluded from this analysis.

RESULTSThere were 92,332 patients admitted to the general paediatric wards. The 7 leading causes for admission accounted for 62% of all admissions: gastroenteritis (14%), upper respiratory tract infections (12%), asthma/wheezy bronchitis (10%), pneumonia (10%), bronchiolitis (6%), febrile convulsions (7%) and other convulsions (4%). Across almost all categories, there was a consistent excess of males (59.1% of all admissions). The male excess was even more pronounced for urinary tract infections (72%) and nephrotic syndrome (80%). The main sub-categories without this male predominance were accidents, accidental ingestion and social admissions (50% males), failure to thrive (49% males), acyanotic congenital heart disease (48%), endocrine (42%), auto-immune conditions (30%) and attempted suicide (19%).

CONCLUSIONSAlthough male vulnerability to illness has long been recognised, the consistency and magnitude of these gender differentials in admissions was impressive. More vigorous exploration of the underlying mechanisms responsible for this phenomenon is warranted.

Adolescent ; Child ; Child, Preschool ; Female ; Gastrointestinal Diseases ; epidemiology ; Heart Diseases ; epidemiology ; Hematologic Diseases ; epidemiology ; Hong Kong ; epidemiology ; Hospitals, University ; utilization ; Humans ; Infant ; Kidney Diseases ; epidemiology ; Male ; Patient Admission ; statistics & numerical data ; Respiratory Tract Diseases ; epidemiology ; Retrospective Studies ; Sex Factors

Acute Kidney Injury ; epidemiology ; pathology ; Adolescent ; Adult ; Aged ; Biopsy, Needle ; methods ; China ; epidemiology ; Female ; Glomerulonephritis, Membranoproliferative ; epidemiology ; pathology ; Humans ; Kidney ; pathology ; Kidney Diseases ; epidemiology ; pathology ; Male ; Middle Aged ; Nephrotic Syndrome ; epidemiology ; pathology ; Ultrasonography, Interventional

BACKGROUND/AIMS: The aim of this study was to examine the recent clinical trends and antibiotic susceptibilities of the causative microorganisms in renal and perirenal abscesses, and to elucidate the factors associated with treatment strategies. METHODS: We retrospectively analyzed 56 patients who were diagnosed with renal and perirenal abscesses at our hospital from January 2000 to September 2007. RESULTS: The mean age of the patients was 53.5 years, and a female predominance of patients (75%) was observed. Diabetes mellitus (44.6%) was the most common predisposing condition. The mean duration of symptoms before diagnosis was 11.6 days, and fever (75%) was the most common symptom. Escherichia coli (44%) and Klebsiella pneumoniae (28%) were common pathogens, and the rates of susceptibility of E. coli isolates to ampicillin, cephalothin, cefotaxime, trimethoprim-sulfamethoxazole, ciprofloxacin, gentamicin, and imipenem were 18.2%, 27.3%, 72.7%, 72.7%, 63.6%, 63.6%, and 100%, respectively. Abscesses were classified according to the location as follows: renal abscess (n=31, 55.4%) and perirenal abscess +/- renal abscess (n=25, 44.6%). In the renal abscess group, the infection rate of gram-negative organisms was higher than in the perirenal abscess group. Patients were also divided according to the treatment modality: antibiotics only (n=20, 35.7%) and percutaneous intervention or surgery (n=36, 64.3%). Patients who had a perirenal abscess or a large renal abscess required more invasive treatment. CONCLUSIONS: This study revealed somewhat different results from those of previous studies. Clinical and microbial differences were observed between the renal and perirenal abscess groups. Abscess location and the size of the renal abscess were the factors associated with treatment strategies.
Abdominal Abscess/*diagnosis/epidemiology/microbiology ; Disease Susceptibility ; Female ; Humans ; Kidney/*microbiology ; Kidney Diseases/*diagnosis/epidemiology/microbiology ; Korea/epidemiology ; Male ; Middle Aged ; Retrospective Studies

To evaluate the distribution and changing patterns of renal diseases in Korea, a total of 4,514 cases of renal biopsy collected over a 23-year period between 1973 and 1995 were reviewed. Of 4,200 cases excluding 314 unsatisfactory biopsies, adult cases comprised 59.5% and pediatric cases, 40.5%. The male to female ratio was 1.5:1 in adults and 2.2:1 in children. Glomerulonephritis (GN) comprised 80.0% of the total. The most common primary GN in adults was minimal change disease (MCD) (26.6%), followed by IgA nephropathy (IgAN) (22.1%), membranous GN (MGN) (11.8%), and membranoproliferative GN (MPGN) (5.9%). In children, the primary GN incidence rates were MCD (24.8%), IgAN (10.3%), poststreptococcal (including postinfectious) GN (PSGN) (8.6%), and focal segmental glomerulosclerosis (FSGS) (4.0%). The most common secondary GN in adults was lupus nephritis and in children Henoch-Schonlein purpura nephritis. The most common cause of nephrotic syndrome was MCD in both adults and children, followed by MGN and FSGS. The elderly, aged sixty years and older, comprised 2.7% of cases and recorded equal numbers of MCD and MGN. The proportion of the biopsies found to be seropositive for HBs antigen was 27.9%, and these showed either MGN or MPGN pattern. Repeat biopsy was performed in 168 patients, due to previous biopsy failure in 15.5%. When the primary GN cases were analyzed at 5-year intervals, the prevalence of PSGN, which was greater than 25% during the 1973-1982 period, decreased abruptly in children thereafter, whereas the prevalence of FSGS increased slowly since the 1988-1992 period in both adults and children. The decrease of PSGN and the increase of FSGS suggest a role for socioeconomic and environmental factors in Korea.
Adult ; Age Distribution ; Biopsy ; Child ; Female ; Glomerulonephritis/pathology ; Glomerulonephritis/epidemiology ; Glomerulosclerosis, Focal/pathology ; Glomerulosclerosis, Focal/epidemiology ; Human ; Kidney/pathology* ; Kidney Diseases/pathology* ; Kidney Diseases/epidemiology* ; Korea ; Male ; Middle Age ; Prevalence ; Sex Distribution

China ; Diabetic Nephropathies ; epidemiology ; metabolism ; pathology ; Glomerulonephritis, IGA ; epidemiology ; metabolism ; pathology ; Humans ; Kidney Diseases ; epidemiology ; metabolism ; pathology ; Lupus Nephritis ; epidemiology ; metabolism ; pathology

OBJECTIVETo analysis the pathological demography in Chinese patients undergoing renal biopsy from our nephrology center.

METHODSBetween January 1979 and October 2000 in Jinling Hospital, Nanjing, China, 10,002 attempts of percutaneous renal were performed in patients with renal disease from 33 provinces of China. The pathological classifications were made according to the WHO criteria of 1982 for renal pathology or the modified WHO criteria of 1995 by a panel of pathologists and nephrologists during routine clinical-pathological rounds. The pathological demography between those specimens collected from 1979 - 1989 and those from 1990 - 1999 was compared.

RESULTSThe mean age of the 10,002 subjects undergoing renal biopsy was 31.4 +/- 13.0 years (ranging from 1 to 78 years), with a male to female ratio of 1.3:1; for the 592 renal transplant recipients, the mean age was 37.5 +/- 9.1 years (ranging from 16 to 66 years), with a male to female ratio of 2.36:1. Primary glomerular diseases (PGD) accounted for 71% of the total patients undergoing renal biopsies, secondary glomerular nephritis (SGN) 23%, tubular-interstitial diseases 3.2%, unclassified renal diseases 1.3%, hereditary and congenital renal diseases 1.0%, end stage renal diseases 0.96%, and recently realized or rare renal diseases 0.15%. IgA nephropathy (IgAN) was the most frequent pathological pattern (40%) of PGD, followed by mesangial proliferative lesion (MsPL) (30%), membranous nephropathy (MN) (10%), and focal segmental glomerulosclerosis (FSGS) (6%). Lupus nephritis (LN) was the most pathology common seen (74%) in SGN. During the 22 years of the study period, there was a steady increase in patients with SGN discovered during pathological evaluation of renal disorders. A rise in prevalence was found in IgA nephropathy, MN (both P < 0.001), crescentic glomerulonephritis (P < 0.0001), anti-GBM disease, and hemolytic-uremic syndrome/thrombotic thrombocytopenic purpura related renal damages (both P < 0.001). There was a decrease in endocapillary proliferative glomerulonephritis (P < 0.001) and IgM nephropathy (IgMN) (P < 0.01) from 1990 - 1999 as compared to 1979 - 1989. Infrequent renal pathological entities were also diagnosed in this group, including Niemann Pick disease, Fabry's disease, POEMS syndrome, and lipoprotein glomerulonephropathy.

CONCLUSIONSThis is the largest series of renal biopsy data in China, and therefore may reflect the demographic picture of renal diseases in this country. Changes in prevalence of renal pathological entities were reflected in this group of patients over the last 22 years. In primary glomerular diseases, IgA nephropathy is still the most frequently observed pathological pattern. In SGN, LN appeared the most often. Increased prevalence was found in anti-GBM nephritis and HUS/TTP.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Japan ; epidemiology ; Kidney Diseases ; epidemiology ; pathology ; Male ; Middle Aged ; Prevalence

OBJECTIVETo explore lupus nephritis (LN) patients' monocyte chemotactic protein 1 (MCP-1) and urinary IP-10 (ulP-10) levels, the correlation between each clinical activity index and rheumatism syndrome, thereby proving objective evidence for microscopic typing of rheumatism syndrome.

METHODSTotally 60 LN patients were assigned to the rheumatism group (31 cases) and the non-rheumatism group (29 cases). Besides, 20 healthy volunteers were recruited as the normal control group. Clinical data and renal pathology were collected, and urinary levels of MCP-1 and IP-10 detected by ELISA. The correlation between rheumatism syndrome and each activity index as well as manifestations of clinical activities was comprehensively analyzed. Results (1) Patients in the rheumatism group were more liable to occur fever, serositis, edema, and hypertension (P<0.05). (2) Compared with the non-rheumatism group, patients in the rheumatism group exhibited much higher levels of 24 h protein quantification and blood urea nitrogen, higher levels of uMCP-1 and ulP-10. Microscopic hematuria, anti-ds-DNA, anti-Sm, the positive rate of AnuA, scores of SLEDAI and BILAG were higher in the rheumatism group than in the non-rheumatism group (P<0.05). Levels of plasma albumin and complement C3 were lower in the rheumatism group than in the non-rheumatism group (P<0.05). (3) The average activity index (AI) of the renal pathology was higher in the rheumatism group than in the non-rheumatism group. The most frequent pathological type of rheumatism group was type IV of LN.

CONCLUSIONSMore severe renal damage and immune abnormality occurred in LN patients of rheumatism syndrome. Rheumatism syndrome is closely correlated to clinical activity indices.

Biomedical Research ; Chemokine CCL2 ; metabolism ; Complement C3 ; metabolism ; Hematuria ; Humans ; Kidney ; Lupus Nephritis ; epidemiology ; metabolism ; Rheumatic Diseases ; epidemiology ; metabolism

OBJECTIVETo observe the effect of blood activating and cooling, stasis removing herbs on the occurrence rate of Henoch-Schonlein purpura nephritis (HSPN).

METHODSThe 141 HSP children patients with bleeding of the blood stasis syndrome and of the blood heat syndrome (having normal results of urine routines) were assigned to the blood activating and stasis removing group and the blood cooling and arresting group. They were treated with blood activating and stasis removing herbs and blood cooling and arresting herbs respectively for eight weeks. The occurrence rate and time of the renal injury, changes of transforming growth factor (TGF), D-dimer (D-D), immunoglobulin (Ig), urine micro-protein, and urease before and after treatment were observed.

RESULTSThe occurrence of the renal injury in the blood activating and stasis removing group was 36.2%, obviously lower than that in the blood cooling and arresting group (69.4%). The occurrence time of the renal injury was 32.2 +/- 10.6 days, obviously later than that in the blood cooling and arresting group (20.0 +/- 9.0 days), showing statistical difference (P<0.05). The levels of TGF, D-D, IgA, microglobulin (MG), immunoglobulin G (IgG), albuminuria (ALB) of children patients in the blood activating and stasis removing group were lower after treatment than before treatment, showing significant difference (P<0.05). Significant difference was also shown when compared with those of the blood cooling and arresting group (P<0.05).

CONCLUSIONThe application of activating blood and removing stasis method could lower the probability of the renal injury in Henoch-Schonlein purpura (HSP). It played a role in preventing the occurrence of HSPN.

Child ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Incidence ; Kidney Diseases ; epidemiology ; Male ; Phytotherapy ; Purpura, Schoenlein-Henoch ; drug therapy ; epidemiology