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[Epidemiology of primary glomerulonephritis in Picardie]
Z Abdulmassih1, R Makdassi, N Bove
1Service de Néphrologie-Médecine Interne, Hôpital Sud, Amiens.
Insights
This study tracked primary glomerulonephritis diagnoses over a decade, finding shifts in disease types and increasing incidence of IgA nephropathy, particularly in men. Findings suggest potential links to infections and polymedication in older adults.
Area of Science:
- Nephrology
- Epidemiology
- Histopathology
Context:
- A decade-long epidemiological study (1976-1986) in a region of 675,000 inhabitants.
- Investigated the prevalence and incidence of primary glomerulonephritis.
- Utilized histological diagnoses from renal biopsies.
Purpose:
- To analyze trends in primary glomerulonephritis incidence and prevalence.
- To identify changes in the distribution of specific glomerulonephritis subtypes.
- To explore potential associations with age, sex, and environmental factors.
Summary:
- Primary glomerulonephritis prevalence was 0.4/1000 inhabitants, with annual incidence rising from 3.4 to 4.5 per 100,000.
- Berger's disease (IgA nephropathy) was most common and increasing; acute and membranoproliferative forms decreased.
- Membranous glomerulonephropathy and minimal change disease increased in older adults, possibly due to polymedication.
Impact:
- Highlights regional variations in glomerulonephritis epidemiology, potentially influenced by healthcare access.
- Suggests differing pathogenetic links for glomerulonephritis subtypes, particularly concerning infections.
- Indicates a need to consider medication effects in the elderly with specific kidney diseases.
Abstract:
Between 1 January 1976 and 31 December 1986, primary glomerulonephritis was histologically diagnosed in 319 patients, living in a region of 675,000 inhabitants at the time of renal biopsy. The prevalence of primary glomerulopathy was 0.4/1000 inhabitants. The annual incidence was determined during two 5 year periods: period A (1976-1980) and period B (1981-1985): they were, respectively, 3.4 and 4.5 for 100,000 inhabitants. Berger's focal glomerulonephritis was the most common (30 p. 100) and its incidence was increasing. In contrast, membranoproliferative and acute glomerulonephritides were sharply decreased (almost disappeared), while membranous glomerulonephropathies and glomerulopathies with minimal glomerular lesions or proliferative forms with crescents increased. All primary glomerulonephritides were more prevalent in men and their frequencies increased with age. Our findings lead to the following conclusions: a) the low prevalence and incidence of primary glomerulopathies (3 times less than in other published studies) probably reflect the under medicalization of our region and the attractiveness of neighbouring metropolis, rather than a real decrease in the disease; b) the quasi- disappearance of acute and membranoproliferative glomerulonephropathies and the high incidence of IgA glomerulonephropathies suggest that their pathogenetic associations with infections sensitive to antibiotics are different; c) the increased frequency of membranous glomerulonephropathy and the glomerulopathy with minimal glomerular lesions in aged subjects is most likely due to their polymedication.