Prevalence and 20-year epidemiological trends of glomerular diseases in the adult Saudi population: a multicenter study

• Main Authors: Talal AlFaadhel, Abdulkareem Alsuwaida, Khaled Alsaad, Lamees Almezaini, Noura Ahmed, Mahmoud Yassin AlHamad, Ammar Bakheet, Junaid Wadera, Ghadeer Mokhtar, Feras Alsuwaida, Rehan Siddiqui, Mohamed Kechrid, Ashraf Abdelrehman, Sufia Husain, Hala Kfoury, Abdulrahaman Alabdulsalam, Majed Alanazi, Noura Al Oudah, Hanadi AlHozali
• Format: Article
• Language: English
• Published: King Faisal Specialist Hospital and Research Centre 2019-05-01
• Series: Annals of Saudi Medicine
• Online Access: https://www.annsaudimed.net/doi/full/10.5144/0256-4947.2019.155

BACKGROUND: Recent international reports have shown significant changes in the incidence of different glomerular diseases. OBJECTIVE: Examine temporal and demographic trends of biopsy-diagnosed glomerular diseases in the adult population of Saudi Arabia over the last two decades. DESIGN: Medical record review. SETTINGS: Four tertiary medical centers in Saudi Arabia. PATIENTS AND METHODS: We identified all patients that underwent native kidney biopsy between 1998 and 2017. MAIN OUTCOME MEASURES: The frequency and the disease trends in four biopsy eras (1998–2002, 2003–2007, 2008–2011, and 2012–2017) for different glomerular diseases. SAMPLE SIZE AND CHARACTERISTICS: 1070 patients, 18-65 years of age; 54.1% female. RESULTS: Of 1760 patients who underwent native kidney biopsies, 1070 met inclusion criteria. Focal segmental glomerulosclerosis was the most common biopsy-diagnosed disease, with comparable frequencies over the four eras (23.6%, 19.8%, 24.1%, and 17.1, respectively [P value for trend=.07]). The frequency of immunoglobulin A nephropathy increased progressively. The incidence of membranoproliferative glomerulonephritis declined significantly. Among the secondary types of glomerular diseases, systemic lupus erythematosus-associated lupus nephritis was the most common, followed by diabetic nephropathy. The prevalence of diabetic nephropathy increased from 1.4% in the first era to 10.2% in the last one. CONCLUSIONS: Trends in biopsy-diagnosed glomerular disease have changed. While focal segmental glomerulosclerosis remains the most common glomerular disease, there has been a significant rise in the prevalence of immunoglobulin A nephropathy and diabetic nephropathy. In contrast, membranoproliferative glomerulonephritis has declined. LIMITATIONS: Retrospective methodologies are vulnerable to lost data. CONFLICT OF INTEREST: None.