The spectrum of biopsy-proven renal disease among Tibetan inhabitants: A survey of 429 patients at a single Chinese center

Abstract Background The renal histopathology of Tibetan inhabitants with renal diseases has not been well described. The purpose of the study was to investigate the spectrum of renal diseases on the Tibetan Plateau. Methods The records of 429 consecutive native renal biopsies performed on patients at the People’s Hospital of Tibet Autonomous Region between January 2016 and July 2020 were retrospectively analyzed. The kidney tissues were sent to the Department of Nephrology, Peking University First Hospital, for pathological evaluation. The criteria for renal biopsy and pathologic diagnosis were kept unchanged. Results Of the 429 biopsies evaluated, 60.4% (259/429) were from males. A total of 14.0% (60/429) of patients were elderly (age ≥ 60 years). Nephrotic syndrome (NS) was the most common clinical presentation, accounting for 47.1% (196/416). On histology, 63.2% (271/429) of patients were diagnosed with primary glomerulonephritis (PGN), and 29.4% (126/429) of patients were diagnosed with secondary glomerulonephritis (SGN). Membranous nephropathy (MN) was the most common PGN, accounting for 31.0% (84/271), followed by IgA nephropathy (IgAN) (29.5%, 80/271) and minimal change disease (MCD) (15.5%, 42/271). The leading SGN was diabetic nephropathy (DN) (42.9%, 54/126), followed by IgA vasculitis-associated nephritis (IgAVN) (15.9%, 20/126). Conclusions The largest retrospective cohort study of biopsy-proven renal disease in Tibetan inhabitants revealed that the leading causes of primary glomerular disease were MN and IgAN and that the leading cause of secondary glomerular disease was DN.