Changing prevalence of glomerular diseases in Korean adults: a review of 20 years of experience

Nephrol Dial Transplant. 2009 Aug;24(8):2406-10. doi: 10.1093/ndt/gfp091. Epub 2009 Mar 4.

Abstract

Background: The prevalence of glomerular diseases differs according to geographic area, race, age and indications for a renal biopsy. This study was conducted to evaluate the distribution and changing patterns of renal diseases during the past 20 years in a large patient population in Korea.

Methods: Patients aged 16 years or older who underwent a renal biopsy at Severance Hospital in the Yonsei University Health System from 1987 to 2006 were enrolled. All medical records were reviewed retrospectively.

Results: In total, 1818 patients (M:F = 1.02:1) were reviewed. Glomerulonephritis (GN) comprised 85.9% of the total biopsied cases. The most common primary GN was IgA nephropathy (IgAN) (28.3%), which was followed by minimal change disease (MCD) (15.5%), membranous nephropathy (MN) (12.3%), focal segmental glomerulosclerosis (FSGS) (5.6%) and membranoproliferative GN (MPGN) (4.0%). The most common secondary GN was lupus nephritis (8.7%). The most common idiopathic nephrotic syndrome was MCD (38.5%), which was followed by MN and IgAN. Among 128 (7.4%) patients who were HBsAg-positive, MN (30.5%) and MPGN (21.1%) were the most common GN. When the incidence rates between 1987-91 and 2002-06 were compared, IgAN increased from 25.6 to 34.5%, while MCD (from 23.2 to 7.0%) and MPGN (from 6.7 to 1.7%) decreased significantly (P < 0.01).

Conclusions: IgAN was the most common primary GN, and MCD was the most common cause of nephrotic syndrome. In the 5-year quartile comparison, the relative frequency of IgAN increased, while the relative frequency of MCD and MPGN decreased significantly during the past 20 years.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Glomerulonephritis / epidemiology*
  • Glomerulonephritis / pathology
  • Glomerulonephritis, IGA / epidemiology
  • Glomerulonephritis, IGA / pathology
  • Glomerulonephritis, Membranous / epidemiology
  • Glomerulonephritis, Membranous / pathology
  • Glomerulosclerosis, Focal Segmental / epidemiology
  • Glomerulosclerosis, Focal Segmental / pathology
  • Humans
  • Korea / epidemiology
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Time Factors
  • Young Adult