Temporal and Demographic Trends in Glomerular Disease Epidemiology in the Southeastern United States, 1986–2015

Abstract

We identified significant changes in relative renal biopsy frequencies of many glomerular disease subtypes over three decades. Temporal trends were consistently observed within all major demographic groups, although relative predominance of individual glomerular disease subtypes differed according to patient age, sex, and race. We propose that exploration of behavioral and environmental exposures that likely underlie these findings should be the focus of future hypothesis-driven research.

Changes in the Spectrum of Kidney Diseases: An Analysis of 40,759 Biopsy-Proven Cases from 2003 to 2014 in China

“…IgAN and FSGS, although IgAN is still the most common PGN. A similar finding was also observed in other Chinese subpopulations [17], while the frequency of IgAN has remained stable in the USA [23]. The decline in FSGS frequency has been previously observed in the Chinese population [17].…”

“…The decline in FSGS frequency has been previously observed in the Chinese population [17]. Previous studies from the USA showed an increase in the frequency of FSGS, which was followed by a plateau and decline in its frequency in the 21st century [23].…”

“…Previous studies [10][11][12][13][14][15][16][17] indicated that in China the majority of patients aged >60 years who underwent renal biopsy had MN, especially patients aged ≥65 years. Studies have also shown that MN has increased significantly in India [18] and Brazil [19], while it decreased in Japan [20], Korea [21], the USA [22,23], and the UK [24]. In addition to geographical and genetic factors, the increase in MN in China and the decrease in MN in developed countries might be related to environmental exposures, industrialization, and lifestyle changes [15].…”

ANCA Glomerulonephritis and Vasculitis

“…Epidemiology, Demographics, and Genetics MPA, GPA, and EGPA have a peak incidence of 65-75, but may occur at any age, with a slight male predominance (12). Figure 3 shows data derived from 21,374 patients with any form of glomerular disease identified in renal biopsy specimens evaluated by the University of North Carolina Nephropathology Laboratory from 1986 to 2015 (13). Only a subset of the most common glomerular disease categories that cause GN are shown on these graphs.…”

“…Only a subset of the most common glomerular disease categories that cause GN are shown on these graphs. In patients with GN ,60 years old, lupus nephritis and IgA nephropathy are diagnosed most often, whereas ANCA GN is diagnosed most often after 60 years old (13). As a percentage of all biopsies performed in different age groups (panel on the right in Figure 3), IgA nephropathy declines with age, lupus nephritis peaks in early adulthood, and ANCA GN increases with age, with a dramatic surge after 50 years old.…”