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

Nephrology (Carlton). 2017 Feb;22(2):168-173. doi: 10.1111/nep.12739.

Abstract

Aim: Primary glomerular disease (PGD) remains the most common renal disease in China. A limited number of single centre studies show that the frequency of membranous nephropathy (MN) has increased; however, IgA nephropathy (IgAN) is still the most common PGD. To the best of our knowledge, there has been no multi-centre study in China that has explored the changes in PGD spectrum. To further investigate the changes in renal histopathological spectrum, we performed the cross-sectional study.

Method: From June 2010 to May 2015, 5935 patients from 37 hospitals in Shandong Province were involved in this retrospective study. The study was divided into five periods according to 1-year intervals. The patients were divided into four age groups (≤18 years, 19-44 years, 45-59 years and ≥60 years).

Result: Among the 5935 qualified specimens, 4855 (81.8%) were diagnosed with PGD. MN (43.3%) became the most common PGD instead of IgA (34.1%) (P < 0.001). The frequency of MN was increased from 30.7% in period 1 to 53.5% in period 5 (P < 0.001). The prevalence of MN tended to increase in every age section. IgA was the main cause of PGD in periods 1 and 2; however, its proportion decreased significantly from 41.8% in period 2 to 25.2% in period 5 (P < 0.001).

Conclusion: Primary glomerular disease remains the most common renal disease in our study. For the first time, this cross-sectional study suggests that MN, in place of IgAN, has grown to be the first leading pathological type of PGD.

Keywords: IgA nephropathy; histopathology; membranous nephropathy; primary glomerular diseases.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Biopsy
  • Child
  • Child, Preschool
  • China / epidemiology
  • Cross-Sectional Studies
  • Female
  • Glomerulonephritis, IGA / diagnosis
  • Glomerulonephritis, IGA / epidemiology*
  • Glomerulonephritis, Membranous / diagnosis
  • Glomerulonephritis, Membranous / epidemiology*
  • Health Surveys
  • Humans
  • Infant
  • Kidney / pathology
  • Male
  • Middle Aged
  • Prevalence
  • Retrospective Studies
  • Time Factors
  • Young Adult