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Abstract
Aim To determine the prevalence and frequency of different pathological patterns of glomerulonephritis (GN) in adolescent (age ≥ 11 years) and adult Jordanian patients. Materials and Methods A retrospective analysis of all clinical and pathological reports of Jordanian patients who had native renal biopsies at the University of Jordan hospital between January 2007 and March 2018 to assess the prevalence and pathological pattern of GN. The data were analyzed statistically using descriptive statistics, the chi-squared test, and Fisher's exact tests. The level of significance was set at P < 0.05. Results Two hundred and nine patients (88 males and 121 females) had native kidney biopsies diagnosed as having GN; the mean age at the time of biopsy was 36.0 ± 14.9 years. Primary GN (51.2%) was more common than secondary GN (48.8%). The most common GN was lupus nephritis (LN) (33.5%), followed by membranous nephropathy (MGN) (15.3%), and diabetic nephropathy (DN) (11.0%). Furthermore, IgA nephropathy was noted in 8.1% of cases. LN was the most common among the secondary GN and occurred in 49.6% of females; MGN was the most common primary GN and occurred in 22.7% of males. There was a statistically significant difference between males and females in the prevalence of LN and MGN (P < .001 and P = .011, respectively). LN was also dominant in all age groups expect for the ≥60 years group, which tended to exhibit DN (40%). Conclusion LN is the most common GN type in Jordan, followed by MGN and DN. MGN is the predominant primary GN with a higher prevalence among males; LN is the predominant secondary GN and tends to occur in Jordanian females. The GN patterns in this study shifted from membranoproliferative GN to MGN in Jordan, which revealed a shift towards similar patterns exhibited in developed countries. Furthermore, DN is the most frequent GN in the elderly.
Highlights
Glomerulonephritis (GN) is a generic term for glomeruli injuries, which may range from massive inflammatory injuries that largely destroy the glomerulus to the injuries that can only be detected using sensitive techniques such as electron microscopy
GN is one of the main causes of chronic kidney disease and end-stage renal disease (ESRD) worldwide, which are responsible for major morbidity and mortality worldwide [1]
The most common type of GN was lupus nephritis (33.5%), followed by membranous nephropathy (15.3%), and diabetic nephropathy (11.0%); the least common types of GN were Alport syndrome with an incidence of less than 1% and amyloidosis, crescentic GN, and postinfectious GN with an incidence of 4 (1.9%) each (Table 1, Figure 1)
Summary
Glomerulonephritis (GN) is a generic term for glomeruli injuries, which may range from massive inflammatory injuries that largely destroy the glomerulus to the injuries that can only be detected using sensitive techniques such as electron microscopy. GN is one of the main causes of chronic kidney disease and end-stage renal disease (ESRD) worldwide, which are responsible for major morbidity and mortality worldwide [1]. To establish a definitive diagnosis of GN and specify the pattern of glomerular injury, a histopathological and immunohistochemical analysis of the tissues typically obtained from patient’s kidney via renal biopsy is necessary. Each type of GN has a specific histopathological pattern but does not have a specific clinical entity [2]. When glomeruli involvement is part of a systemic disease such as connective tissue diseases, systemic lupus erythematosus, systemic vasculitis, and infective endocarditis. The mechanisms of glomerular injury are still not fully understood [3]
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