Glomerulonephritis disease pattern at Saudi tertiary care center

AlMatham, Khalid; Alfayez, Ali; AlHarthi, Raghdah A; AlMutairi, Falah S; Alrasheedi, Fahad S; Mustafa, Abdulrehman; Ahmed, Mustafa M.; AlMatouq, Basim A; AlRowaei, Fadil A

doi:10.15537/smj.2017.11.21119

Cited by 12 publications

(18 citation statements)

References 14 publications

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“…Interestingly, the majority of SLE adult patients were also class IV LN. 10 In our cohort, a high titre of ANA was significantly associated with higher disease activity, consistent with previous studies. 11 However, a high titre of anti-dsDNA showed an insignificant pattern (1:80; p =0.052) of association with a higher SLEDAI score.…”

Section: Discussionsupporting

confidence: 93%

Pediatric systemic lupus erythematosus

Nazri

Wong²,

Hamid³

2018

SMJ

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Objectives:To elucidate the clinico-laboratory characteristics associated with pediatric systemic lupus erythematosus (pSLE) patients with higher Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score in a retrospective cohort of pSLE patients.Methods:A retrospective study involving 32 pSLE patients was conducted at Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2006 and 2017.Results:Within the group of 32 pSLE patients, 23 were girls and 9 were boys (3:1 ratio). The most common symptom was renal disorder (n=21; 65.6%) followed by malar rash (n=9; 28.1%), oral ulcers (n=7; 21.9%), prolonged fever (n=5; 15.6%) and arthritis (n=4; 12.5%). Antinuclear antibodies (ANA) were detected in all patients and 25 patients (78.1%) were positive for anti-double stranded DNA (anti-dsDNA) antibodies. Eighteen (56.3%) patients had active SLE (SLEDAI ≥6), and these patients were significantly associated with heavy pyuria (p=0.004), a high ANA concentration (1:160; p=0.040, 1:320; p=0.006), elevated ESR (p=0.006), low C3 levels (p=0.008), oral ulcers (p=0.010), heavy hematuria (p=0.017) and heavy proteinuria (p=0.017), lupus erythematosus (LE)-nonspecific lesion manifestations (p=0.019) and malar rash (p=0.044).Conclusion:Pediatric systemic lupus erythematosus patients with higher SLEDAI score were most significantly associated with pyuria, high ANA titers, and elevated ESR.

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Section: Discussionsupporting

confidence: 93%

Pediatric systemic lupus erythematosus

Nazri

Wong²,

Hamid³

2018

SMJ

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“…MPGN and mesangial proliferative GN were each reported in 4.3% of our patients, and these were less prevalent in our cohort compared with that in earlier studies [ 8 – 10 ] owing to an improved infection control; similar results have been reported in recent data from Saudi Arabia [ 22 ] and Dubai [ 21 ].…”

Section: Methodssupporting

confidence: 89%

“…FSGS was reported as the predominant pattern of GN in a previous report from Jordan [ 8 ]; however, it was less prevalent in our study. It is still the most common type of primary GN in Saudi Arabia [ 22 ] and Iran [ 23 ] and the second most common type of primary GN in the United States of America [ 11 ]. FSGS prevalence was underestimated in our study because of the clinical indications of kidney biopsy, changes in nephrologist's practice with advanced renal impairment in the presence of proteinuria and hypertension, and absence of renal disease screening strategies.…”

Section: Methodsmentioning

confidence: 99%

Glomerulonephritis Pattern at a Jordanian Tertiary Care Center

Farah

2018

International Journal of Nephrology

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Aim To determine the prevalence and frequency of different pathological patterns of glomerulonephritis (GN) in adolescent (age ≥ 11 years) and adult Jordanian patients. Materials and Methods A retrospective analysis of all clinical and pathological reports of Jordanian patients who had native renal biopsies at the University of Jordan hospital between January 2007 and March 2018 to assess the prevalence and pathological pattern of GN. The data were analyzed statistically using descriptive statistics, the chi-squared test, and Fisher's exact tests. The level of significance was set at P < 0.05. Results Two hundred and nine patients (88 males and 121 females) had native kidney biopsies diagnosed as having GN; the mean age at the time of biopsy was 36.0 ± 14.9 years. Primary GN (51.2%) was more common than secondary GN (48.8%). The most common GN was lupus nephritis (LN) (33.5%), followed by membranous nephropathy (MGN) (15.3%), and diabetic nephropathy (DN) (11.0%). Furthermore, IgA nephropathy was noted in 8.1% of cases. LN was the most common among the secondary GN and occurred in 49.6% of females; MGN was the most common primary GN and occurred in 22.7% of males. There was a statistically significant difference between males and females in the prevalence of LN and MGN (P < .001 and P = .011, respectively). LN was also dominant in all age groups expect for the ≥60 years group, which tended to exhibit DN (40%). Conclusion LN is the most common GN type in Jordan, followed by MGN and DN. MGN is the predominant primary GN with a higher prevalence among males; LN is the predominant secondary GN and tends to occur in Jordanian females. The GN patterns in this study shifted from membranoproliferative GN to MGN in Jordan, which revealed a shift towards similar patterns exhibited in developed countries. Furthermore, DN is the most frequent GN in the elderly.

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“…Similar to these findings, a recent local publication on data from all renal biopsies identified PLN in 51 out of 63 biopsies with LN, of which 59% were class IV. 35 In a larger local cohort study ( n = 226), among all biopsies with PLN, class IV was found in 69%, class III in 19% and mixed PLN in 12%. 9,10…”

Section: Discussionmentioning

confidence: 93%

Remission and long-term outcomes of proliferative lupus nephritis: retrospective study of 96 patients from Saudi Arabia

Almalki

Al-Rowaie

Alhozali

et al. 2019

Lupus

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Background Few data are available about the rate of short-term remission and its impact on the long-term outcomes of proliferative lupus nephritis in the Middle East. Methods An observational study was carried out involving 96 adult patients with biopsy-proven focal or diffuse proliferative lupus nephritis (PLN) from four different hospitals. Data on induction, remission and long-term outcomes were collected and analyzed. Results Among the 96 patients with biopsy-proven PLN (median age 27 (IQR: 21,34) years, 85% women and median duration of systemic lupus erythematosus (SLE) prior to diagnosis 27 (IQR: 11, 55) months), 67% developed remission at 6 months (proportion 0.67; 95% CI 0.57, 0.76). Mycophenolate mofetil (MMF) was used in 45/96 (47%), CYC in 41/95 (43%) and other agents in 10/96 (10%). The choice of MMF as induction agent has increased in recent years. Among baseline characteristics, only histologic activity was found to have a significant association with remission, with active lesions more likely to remit than active/chronic and chronic lesions (AOR 6.5, 95% CI 1.44–29.39, p = 0.015). Based on Kaplan–Meier analysis, the 5-year renal survival rate without doubling serum creatinine was 73.8%. Compared to patients with complete remission, lower long-term renal survival rates were observed in patients with no remission (89.7 versus 43%, p = 0.001) and partial remission (89.7 versus 77.6%, p = 0.256). The cumulative rate of doubling serum creatinine, dialysis, relapse and death was 23%, 11%, 10% and 5%, respectively, at 48-month median follow up. Conclusion Approximately two-thirds of patients with PLN develop remission in response to standard induction therapy. Remission was negatively associated with the presence of chronic changes in renal biopsy. Overall, MMF is the most commonly used agent to induce remission; however, with more severe disease CYC, is used more frequently. PLN is associated with significant long-term renal outcomes including a 26% cumulative rate of doubling of serum creatinine at 5 years. Initial remission predicts this long-term renal survival.

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Glomerulonephritis disease pattern at Saudi tertiary care center

Cited by 12 publications

References 14 publications

Pediatric systemic lupus erythematosus

Pediatric systemic lupus erythematosus

Glomerulonephritis Pattern at a Jordanian Tertiary Care Center

Remission and long-term outcomes of proliferative lupus nephritis: retrospective study of 96 patients from Saudi Arabia

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