Clinicopathologic Features, Chronic Renal Damage and Short-Term Outcomes of Glomerular Diseases in a Middle East Tertiary Care Center

Abstract

Background Glomerular diseases (GDs) place a significant burden on patients and health-care systems, and they are a leading cause of end-stage renal disease (ESRD) globally. There is no national register for GDs in Egypt, and the outcomes of GDs are not extensively examined. As a result, studying GDs patterns and outcomes, as well as the association between chronic renal injury at presentation and GDs outcome, was of great interest. Methods Patients with biopsy-proven GDs, presenting to an Egyptian tertiary care center were enrolled and prospectively followed-up for 6 months, death or reaching ESRD. Chronic renal damage was assessed at diagnosis by the total renal chronicity. Results Sixty-six individuals with biopsy-confirmed GDs were enrolled in the study. The most common reasons for a renal biopsy were unexplained kidney function decrease (62%), followed by subnephrotic (23%) and nephrotic presentation (15%). The most common histological patterns were diffuse proliferative glomerulonephritis (GN), membranoproliferative GN (MPGN), and sclerosing GN. Primary and secondary GDs made up 30.3% and 69.7% of the cases, respectively. At the end of the 6-month follow-up, 28 patients had recovered their renal function, 19 had advanced to ESRD, and 7 had died. The most significant predictors of renal recovery were hemoglobin level and the total renal chronicity score. Conclusion In this tertiary care center Egyptian cohort, secondary GDs appear to be more frequent than primary GDs, diffuse proliferative GN was the most common histopathological pattern, and rapid renal recovery was not the rule in this short period. The renal chronicity score could accurately predict the renal outcome. Trial Registration: Approval for this study was granted by the Mansoura Faculty of Medicine Institutional Research Board (IRB) (approval no. MD/17.05.13).

Glomerulonephritis pattern based on renal biopsy at the tertiary center of King Abdulaziz University Hospital, Saudi Arabia

“…Also, the available data on glomerulonephritis epidemiology in Middle East countries is limited. [15][16][17] There is currently a lack of agreement about the appropriate indications and clinical worth of conducting a renal biopsy. [18] However, still, it remains the cornerstone for diagnosis, therapeutics and prognosis in glomerulonephritis disease patients.…”