Glomerulonephritis in Singapore: an overview

Area of Science:

• Nephrology
• Pathology
• Immunology

Background:

• Glomerulonephritis (GN) encompasses diverse kidney diseases with varying presentations and prognoses.
• Understanding the epidemiological patterns and histopathological characteristics of GN is crucial for effective management.

Purpose of the Study:

• To present the pattern of glomerulonephritis (GN) based on a large cohort of renal biopsies.
• To analyze the common modes of presentation, histopathological findings, and prognostic factors in different types of GN.

Main Methods:

• Retrospective analysis of 1057 renal biopsies.
• Classification of GN into primary and secondary types.
• Correlation of clinical presentation, histopathology, immunofluorescence findings, and patient outcomes.

Main Results:

• Primary GN constituted 91% of cases, with lupus nephritis being the most common secondary GN.
• Asymptomatic hematuria and proteinuria (41%) and nephrotic syndrome (29%) were the most frequent presentations.
• Mesangial proliferative GN was the predominant histopathological lesion (66% of primary GN).
• Minimal Lesion GN showed an excellent prognosis, while Crescentic GN had a grim outlook.
• Hypertension was a major adverse factor in the rapid progression to end-stage renal failure (ESRF) in IgA nephritis.

Conclusions:

• The study outlines the diverse landscape of GN in Singapore, emphasizing the prevalence of primary GN and specific histopathological types.
• Clinical presentation significantly influences the likely diagnosis and prognosis.
• Identifying unfavorable prognostic indices like proteinuria, hypertension, and specific biopsy findings is vital for predicting long-term renal survival.