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Changes in primary glomerulonephritis in Singapore over four decades
Clinical Nephrology
|January 22, 2019
Summary
Glomerulonephritis patterns in Singapore shifted significantly over four decades, reflecting national development. Focal segmental glomerulosclerosis (FSGS) prevalence dramatically increased in recent years, highlighting evolving renal pathology.
Area of Science:
- Nephrology
- Renal Pathology
- Epidemiology
Background:
- Kidney biopsy patterns for glomerulonephritis (GN) evolve with socioeconomic development.
- Previous studies indicate regional variations in primary GN prevalence across Asia.
Purpose of the Study:
- To document the changing patterns of biopsy-proven glomerulonephritis (GN) in Singapore over four decades.
- To correlate observed shifts in GN prevalence with the nation's socioeconomic transition.
Main Methods:
- Retrospective analysis of 3,289 native kidney biopsies performed over a forty-year period.
- Categorization of glomerulonephritis (GN) types and analysis of their prevalence trends over four distinct decades.
Main Results:
- Mesangial proliferative GN was initially most common, followed by an increase in membranous GN.
- Focal segmental glomerulosclerosis (FSGS) prevalence rose steadily, with a dramatic increase in the most recent decade.
- IgA nephritis prevalence decreased but remains common; membranous nephropathy continues to rise in some Asian countries.
Conclusions:
- Singapore's glomerulonephritis (GN) biopsy patterns have significantly changed, mirroring its development from a third-world to a developed nation.
- Socioeconomic factors are strongly implicated in the observed evolution of renal biopsy findings.
- The increasing prevalence of FSGS globally and in Singapore warrants further investigation into its underlying causes.
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