Spectrum of glomerulonephritis in adult Egyptians: a single-center retrospective study

E. Khaled, Elena Ahmed, Kora Mahmoud, Tawfeek Ahmed, Dewidar Noha
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Abstract

Background Glomerulonephritis (GN) is still the main cause of renal morbidity and mortality in the developing world. Knowledge about the characteristics of GN and its regional trends is mandatory for proper management of chronic kidney disease to decrease the incidence of progression to end-stage kidney disease. The aim of this study is to identify the patterns and frequency of glomerular lesions (biopsy-proven). Patients and methods This is a retrospective study that included 140 adult patients who underwent renal biopsies at Menoufia University Hospitals between August 2017 and December 2019. Patient demographics, clinical, laboratory, and histopathological data were recorded. The obtained data were analyzed using descriptive and inferential statistics. Results The studied patients were 72 (51.4%) males and 68 (48.6%) females, and their mean age was 36.11 ± 14.57 years. Focal segmental glomerulosclerosis (FSGS) was the most frequent cause of primary GN (21.4%) followed by membranous GN (13.6%), minimal change disease (5.7%), and membranoproliferative GN (3.6%). Lupus nephritis (LN) was reported as the most common in secondary GN (18.6%), followed by vasculitis (12.1%), amyloidosis (5.7%), thrombotic microangiopathy (4.3%), and infection-related GN (3.6%). The most common presentation was peripheral edema (80.7%), followed by acute kidney injury (14.3%). FSGS (12.1%) was the most common subtype of primary GN associated with renal insufficiency followed by membranous GN (10%). Vasculitis was the most common subtype of secondary GN associated with renal insufficiency (12.1%) followed by LN (7.1%). Conclusion FSGS and LN are the most common primary and secondary GN, respectively. Nephrotic syndrome and acute kidney injury were the major indications for biopsy. LN carried the best prognosis, while vasculitis carried the worst prognosis.
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埃及成人肾小球肾炎谱:一项单中心回顾性研究
背景肾小球肾炎(GN)仍然是发展中国家肾脏发病率和死亡率的主要原因。了解肾小球肾小球的特征及其区域趋势对于正确管理慢性肾脏疾病以减少进展为终末期肾脏疾病的发生率是必需的。本研究的目的是确定肾小球病变的模式和频率(活检证实)。这是一项回顾性研究,纳入了2017年8月至2019年12月在Menoufia大学医院接受肾脏活检的140名成年患者。记录患者人口统计学、临床、实验室和组织病理学数据。所得数据采用描述性统计和推理统计进行分析。结果男性72例(51.4%),女性68例(48.6%),平均年龄36.11±14.57岁。局灶节段性肾小球硬化(FSGS)是原发性GN最常见的病因(21.4%),其次是膜性GN(13.6%)、微小病变(5.7%)和膜增生性GN(3.6%)。狼疮性肾炎(LN)是继发性GN中最常见的(18.6%),其次是血管炎(12.1%)、淀粉样变(5.7%)、血栓性微血管病(4.3%)和感染相关性GN(3.6%)。最常见的表现是外周水肿(80.7%),其次是急性肾损伤(14.3%)。FSGS(12.1%)是与肾功能不全相关的原发性肾脏病最常见的亚型,其次是膜性肾脏病(10%)。血管炎是继发性GN最常见的亚型,与肾功能不全相关(12.1%),其次是LN(7.1%)。结论FSGS和LN分别是最常见的原发性和继发性GN。肾病综合征和急性肾损伤是活检的主要适应症。LN预后最好,血管炎预后最差。
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