Histological pattern of primary glomerular diseases among adult Sudanese patients: A single center experience

In Sudan, like most developing countries, the incidence and histologic patterns of primary glomerulonephritis (GN) remains undetermined. A cross-sectional hospital-based prospective study was performed to determine the pattern of primary GN among adult Sudanese patients. The study was conducted at Khartoum Teaching Hospital from September 2010 to August 2011. It included all adult patients with suspected primary glomerular disease and who underwent native kidney biopsy. A total of 83 adult patients were biopsied with 71 patients (85.5%) being diagnosed as having primary GN. Among those with primary GN the mean age was 34.6 ± 18 years and males represent 54.9%. In 46.5% kidney biopsy was indicated by the presence of nephrotic syndrome, whereas in 33.8% biopsies were performed due to unexplained elevations in renal parameters. Primary focal segmental glomerulosclerosis (FSGS) was diagnosed in 29.6% of patients, followed by membrano-proliferative glomerulonephritis (MPGN) in 26.8% and minimal change disease in 16.9%. IgA nephropathy was observed in 5.6%. Complications following kidney biopsies were reported in 9.6% of biopsied patients. Nephrotic syndrome in an adult was the most common indication for kidney biopsy in our unit. A large number of patients were biopsied due to elevated renal parameters, which reflected the increasing awareness toward thoroughly diagnosing patients with suspected reversible kidney damage. In conclusion, FSGS and MPGN make the most common causes of primary GN among Sudanese adults. Creation of a national renal registry is essential for obtaining more specified epidemiological data.