Introduction: Glomerulonephropathies (GNs) have high burden of morbidity and mortality worldwide. The distribution GNs varies significantly due to several factors. Materials and Methods: This retrospective clinico-pathological study estimates the biopsy-proven distribution of primary and secondary GNs and detects the predominant patterns among adult patients who underwent renal biopsy at Nephrology Centre, King Abdul-Aziz Specialist Hospital, Taif City, Kingdom of Saudi Arabia (KSA) from 2008 to 2013 with comparing data to other KSA studies and to other countries. Analysis of possible contributing factors for variation is provided. Relevant patients' data were collected from hospital records. Renal biopsies stained with H&E, Periodic Acid Schiff (PAS), Gomori Methenamine Silver (GMS), Masson Trichrome (MT) and immunofluorescence (IF) were examined and categorized according to the World Health Organization (WHO) classification of glomerular diseases. Comparisons to other studies were set. Results: Primary and secondary GNs comprised 59.4% and 40.6%. Focal segmental glomerulosclerosis (FSGS) was the commonest primary GN (29.3%), followed by minimal change disease (MCD, 22%) then membranous glomerulonephropathy (MGN, 19.5%). IgA nephropathy was the least frequent (IgAN, 2.4%). Lupus nephritis (LN) was the commonest secondary GN (75%), followed by diabetic and vascular nephropathies (DN, 17.9% ; VN, 7.1%). Spatial and temporal variations in GNs distribution existed locally and worldwide. Conclusion:Factors including selection criteria; biopsy rate and indications; local facilities; demographic distribution; racial, ethnic and genetic differences; and prevalence of etiological factors contribute to the variations of GNs distribution. National renal biopsy registry is recommended for obtaining correct distribution of GNs leading to proper prevention and treatment.

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