Strengthening clinical and basic researches on rare kidney diseases

Abstract

Since the reform and opening up 3 decades ago, China′s nephrology has made great achivements after hard work of several generations of Chinese nephrologists; in the diagnosis and treatment for common kidney diseases, especially glomerular diseases, striking progress has been made; and China′s nephrology in some research fields has geared to the international conventions. But as the study foundation of kidney diseases in China is weak, with widespread population and very uneven development, there is still much space for improving China′s diagnosis and treatment of rare kidney diseases, and there is still a long way to go to enhance clinical and basic researches on rare kidney diseases. To achieve this goal, we put forward the following opinions: 1. Standardization of renal biopsy pathologic examination, paying attention to the roles of the immune pathology, and electron microscopy in pathological diagnosis. We emphasize on high quality production and dyeing of pathological specimen; and light microscopy, immunofluorescence, and electron microscopy are all indispensable and mutually complementary. We advocate clinical pathological conference to promote interactions between pathologists and clinical experts. 2. Attaching great importance to the collection and analysis of clinical data, combining genetic screening to effectively improve the diagnosis of rare kidney diseases, and prevent misdiagnosis and failure to diagnose. We emphasize on complete collection of illness history (including familial history) and clinical data (including physical, laboratory, and related medical image examinations) for serious analysis; on the basis of the above, disease-relevant special examination and gene detection for patients with suspected inherited kidney diseases should be performed, in order to avoid failure to diagnose rare secondary renal diseases and genetic diseases or misdiagnosing them as primary kidney diseases. 3. We also advocate active epidemiological investigation and the pathogenesis researches on very harmful rare kidney diseases so as to elucidate the pathogenesis. 4. We should organize high quality clinical therapeutic trials to obtain high quality evidence-based medical data for the purpose of providing guidance and improving the treatment of rare kidney diseases in China. 5. We emphasize individualized treatment and giving full play to the advantages of traditional Chinese medicine for improving the efficacy of rare kidney diseases. Key words: Rare kidney disease; Pathological diagnosis; Clinical data; Pathogenesis; Treatment