Increasing frequency of idiopathic membranous nephropathy in primary glomerular disease: A 10‐year renal biopsy study from a single <scp>C</scp>hinese nephrology centre

Zhu, Ping; Zhou, Fu-de; Wang, Suxia; Zhao, Ming‐Hui; Wang, Haiyan

doi:10.1111/nep.12542

Cited by 67 publications

(58 citation statements)

References 26 publications

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“…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]. Industrialization is inevitably accompanied by environmental pollution, involving heavy metals and organic solvents.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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Objectives: To evaluate the changing spectrum of kidney diseases over time in China using renal biopsy-proven cases. Methods: All patients over the age of 14 years who were diagnosed with a kidney disease by renal biopsy in the Renal Biopsy Registry of the National Clinical Research Center of Kidney Diseases in Jinling Hospital, Nanjing, from 2003 to 2014 were included. Results: In total, 40,759 cases of renal biopsy were analyzed. The mean age of the patients was 36.59 ± 14.12 years. 52.0% of the patients were male. Primary glomerulonephritis (PGN), secondary glomerulonephritis, tubulointerstitial disease, and hereditary renal diseases accounted for 67.1, 26.4, 2.9, and 2.5%, respectively. IgA nephropathy (IgAN), membranous nephropathy (MN), minimal change disease, and focal segmental glomerulosclerosis were the leading PGN diagnoses. The frequency of MN increased significantly (p < 0.001) by doubling from 2003 to 2014. An analysis by age category indicated that the frequency of MN increased significantly over time (p < 0.001) in all age categories and increased by more than 2 times in the 14-24 age category. Lupus nephritis (LN) and Henoch-Schönlein purpura nephritis (HSPN) decreased significantly (p < 0.001), diabetic nephropathy (DN) increased nearly twice (p < 0.001), monoclonal immunoglobulin deposition disease (MIDD) tripled (p < 0.001), and hypertensive nephropathy (HT) (p < 0.001) and renal amyloidosis (AMY) (p < 0.05) showed an upward trend. An analysis by age category showed that hepatitis B-related nephritis has significantly decreased in the 14-24 age category (p < 0.001). Conclusion: PGN continued to be the predominant kidney disease in China with IgAN being the most common PGN. The frequency of MN increased significantly, with a maximum increase in young adults. LN and HSPN decreased significantly, DN and MIDD increased significantly, and HT and AMY also showed an increasing trend. The kidney disease trends presented in this study serve as a reference point for patient care, disease prevention, and public health interventions.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2017

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“…Some recent studies have shown that PGD is still the most common renal disease among patients receiving renal biopsy in China. The prevalence of PGD in renal biopsy specimens has been reported to range from 63.3% to 71.1% . A limited number of single centre studies have shown that the renal histopathological spectrum of proliferative glomerulonephritis (PGN) has continuously changed in recent years.…”

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confidence: 99%

“…A limited number of single centre studies have shown that the renal histopathological spectrum of proliferative glomerulonephritis (PGN) has continuously changed in recent years. One of these changes is the frequency of MN (15.7–29.2%), which has increased significantly . IgAN is still the most common PGD in China and other countries .…”

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Increasing prevalence of membranous nephropathy in patients with primary glomerular diseases: A cross‐sectional study in China

Tang

Yao²,

Kong

et al. 2017

Nephrology

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“…In China, there are little data from epidemiological studies all over the country. One recent study [14] retrospectively analyzed 6,049 renal biopsy patients from a diagnostic referral center and found that the proportion of pMN in primary glomerular disease increased from 17% in the period of 2003–2007 to 29% in the period of 2008–2012 in all age groups. This increase is mainly due to the increase in early stages of pMN in young patients (14–44 years of age).…”

Section: Introductionmentioning

confidence: 99%

The Genetic and Environmental Factors of Primary Membranous Nephropathy: An Overview from China

2018

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Background: Primary membranous nephropathy (pMN) is the most common cause of nephrotic syndrome in adults. The discovery of the 2 autoantigens, M-type phospholipase A2 receptor (PLA2R) and thrombospondin type-1 domain-containing 7A (THSD7A), has defined pMN as an autoimmune disease. A remarkable increase in the frequency of pMN in primary glomerular disease was witnessed in China. The genetic and environmental contributors to disease susceptibility have been investigated in these patients. Summary: We reviewed recent publications in genetic and environmental studies of pMN, focusing mainly on those undertaken in China. Following a genome-wide association study, the gene-gene interaction between the 2 most significant risk factors, PLA2R1 and DQA1, was validated in Chinese patients with MN. Fine mapping on human leukocyte antigen (HLA) locus found that DRB1*1501 and DRB1*0301 were risk alleles. Three amino acid residues on positions 13 and 71 of HLA-DRβ1 chain may confer the susceptibility to pMN by presenting T-cell epitopes on PLA2R. Another study found that DRB3*0202 was the most likely culprit allele for the signal at DRB1*0301. One environmental risk factor for pMN has been identified as the long-term exposure to high levels of PM_2.5 in Chinese patients with MN. Each 10 μg/m³ increase in PM_2.5 concentration was associated with 14% higher odds for pMN in the regions with PM_2.5 above 70 μg/m³. Key Message: A gene-environment interaction is suspected as an underlying mechanism for the increasing trend of pMN in China.

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Increasing frequency of idiopathic membranous nephropathy in primary glomerular disease: A 10‐year renal biopsy study from a single Chinese nephrology centre

Abstract: Our study suggests that the frequency of iMN in PGD in our referral diagnostic centre has doubled over the past 10 years. The increase of adult iMN is mainly due to the increase of early stages of iMN in young patients.

Cited by 67 publications

References 26 publications

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

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

Increasing prevalence of membranous nephropathy in patients with primary glomerular diseases: A cross‐sectional study in China

The Genetic and Environmental Factors of Primary Membranous Nephropathy: An Overview from China

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