Glomerulonephritis Pattern at a Jordanian Tertiary Care Center

Abstract

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.

Morphological Spectrum of Glomerulonephritis in Medical Renal Biopsies: A Single-Center Study

“…In our study, lupus nephritis and advanced glomerulonephritis were the predominant patterns among secondary glomerulonephritis, representing 9.9% of the cases (Figures 2A-2D). In the present series, lupus nephritis with evidence of female predominance was reported in eight (9.9%) cases, which are compatible with several other studies [11,14,15] (Figures 2A-2D). According to a study conducted in the Czech Republic by Dita et al, 23.2% of secondary glomerulonephritis patients have lupus nephritis [21].…”

Characteristics and Histological Types of Lupus Nephritis in a Jordanian Tertiary Medical Center

“…In countries such as the USA and the UK, class III is the second most common class [22, 23]. The increased trend in class V lupus (membranous glomerulopathy, MGN) as a second histological type of LN may be consistent with the increase in MGN in Jordan [4]. This may be related to industrialization, environmental, and behavioral changes, adding to the risk factors for development of LN in men in Jordan who are known to have higher risk of MGN.…”

“…Clinically relevant LN is associated with a 30% decrease in creatinine clearance, proteinuria >500 mg/dl, and renal biopsy findings indicating active LN [3]. Clinical and laboratory findings can be used to predict the histologic type of LN; however, kidney biopsy remains the cornerstone for diagnosis due to the possible toxicity of some treatment protocols and the presence of a significant correlation between histological findings, early diagnosis, and therapy [4].…”

“…As an underlying cause of secondary GN, LN was ranked fifth, responsible for 9.4% of cases in a study by Ghnaimat et al [7]. A further study by Said et al ranked LN as the second most common cause, responsible for 38.8% of secondary GN [8], and it was ranked the commonest cause of secondary GN in studies by Wahbeh et al and Randa et al, responsible for 26.6% and 69% of cases, respectively [4, 9].…”

Lupus Nephritis; Pathogenesis and Treatment Update Review

“…Silent LN occurs, manifesting mostly by an increase of blood pressure with normal serum creatinine and urine analysis (8). Renal biopsy is the gold standard for LN diagnosis and is needed to assess the histological stage, chronicity, and activity that are required before initiating the long-term treatment (9). Despite the advancement of SLE treatment, about 20% of LN patients develop ESRD commonly after 10 years (10).…”