Causes of nephrotic syndrome and nephrotic-range proteinuria are different in adult Chinese patients: a single centre study over 33 years
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The reported causes of nephrotic syndrome (NS) varied between different countries. Less is known about the causes of nephrotic-range proteinuria (NPU).


In this single-centre, retrospective study of adult patients who underwent renal biopsy between 1983-2015 in a tertiary referral hospital in Hong Kong, we aimed to evaluate the underlying causes of NS and NPU. We also determined the distribution of histopathological diagnoses with regard to the age subgroups and time periods


Among 7,456 patients who underwent renal biopsy, 982 and 838 patients had NS and NPU, respectively. The most common diagnosis in NS was minimal change disease (MCD) (33.3%), followed by membranous nephropathy (MN) (23.6%) and lupus nephritis (LN) (12.8%); whereas the most common diagnosis in NPU was LN (27.4%), followed by immunoglobulin A nephropathy (IgAN) (21.4%) and diabetic nephropathy (DN) (9.3%). In the NS group, MCD was the most common diagnosis in young adults while MN was the leading cause in the elderly. On the other hand, LN was the most common pathology in NPU group until the age of 60. Over the past three decades, there was a trend of decrease in the proportion of IgAN in both NS and NPU group, while a combined pathology of hypertensive nephrosclerosis and diabetic nephropathy (HTNS & DN) increased significantly.


The causes of NS and NPU in Chinese adults were different and may represent two distinct pathological identities. The spectrum of renal histopathology among these two groups changed significantly over time.
Acceptance Date15/04/2017
All Author(s) ListJack Kit-Chung Ng, Terry King-Wing Ma, Fernand Mac-Moune Lai, Kai Ming Chow, Bonnie Ching-Ha Kwan, Chi Bon Leung, Philip Kam-To Li, Cheuk Chun Szeto
Journal nameNephrology
Volume Number23
Issue Number6
Pages565 - 572
LanguagesEnglish-United Kingdom

Last updated on 2020-01-07 at 03:12