Introduction: Glomerular diseases are a frequent etiology of chronic kidney disease, especially in the developing countries. Objective: To determine the profile of such glomerulopathies in a public hospital located in the city of Brasilia, Federal District. Methods: 121 renal biopsies in different patients were performed by the Renal Division of Hospital Regional da Asa Norte (HRAN) between August 2005 and May 2009. Eight renal biopsies in renal-transplant patients were excluded and the medical records of 113 remaining patients were analyzed. Analyzed data: sex, age, laboratory exams, glomerular syndrome, clinical diagnosis, degree of interstitial fibrosis, immunosuppressants use, need for dialysis and clinical outcome. Results: The age average was 34.9 ± 16.2 years-old, a predominance of male patients (51.3%). Major glomerular syndromes were: nephrotic syndrome (41.6%) and the rapidly-progressive glomerulonephritis (35.4%). Among primary glomerulopathies focal glomerulosclerosis (26.8%) followed by IgA nephropathy (25%) were predominant; and among the most prevalent secondary glomerulopathies we had lupus nephritis (50%) and diffuse exudative proliferative glomerulonephritis (34.2%).The majority of the patients used immunosuppressants (68.1%) and almost one third of them (29.2%) needed dialysis during their hospitalization. Progressed to chronic dialysis therapy 13.3% of the patients and 10.6% died. Conclusion: This study may contribute to better epidemiological understanding of glomerular diseases in the Federal District, guiding the adoption of public policies aiming the quick clinical treatment of such diseases. Keywords: nephropathy, nephritis, glomerulonephritis, nephrotic syndrome, lupus syndrome, focal segmental glomerulosclerosis, IgA nephropathy, chronic kidney disease [J Bras Nefrol 2010;32(3):248-255]©Elsevier Editora Ltda.
Profile of glomerular diseases in a public hospital of Federal District, Brazil
IntroductIonChronic kidney disease is currently understood as a public health problem, because of its increasing prevalence, high morbidity and mortality, and high costs for maintaining patients with chronic kidney disease (CKD) stage 5 in different modalities of renal replacement therapy (RRT) (hemodialysis, peritoneal dialysis, and kidney transplantation).1-3 Currently, over one million people worldwide are estimated to be on any form of chronic dialysis therapy, and Latin America accounts for almost one quarter of such patients. [4][5][6] The cost of that treatment is high: Brazilian data have shown that more than 10% of the budget of the Health Ministry is destined to maintain RRT programs, while North-American data point to a cost of 29 billion dollars per year to treat patients that need RRT. 7,8 In Brazil, as in several other countries, glomerular diseases are a frequent etiology of chronic kidney failure, 9,10 and kidney biopsy plays a fundamental role in the correct histopathological and etiological diagnosis and even in the prognosis of such cases.
11,12Glomerular diseases often have ...
