Racial differences in the prevalence and presentation of glomerular disease in adults

In order to ascertain to prevalence of glomerulopathies in our patient population, all renal biopsies performed on patients older than 14 years of age presenting to a single military hospital from 1983 to 1992 were reviewed. Two hundred and eighty-five patients were included in the study. Indications for renal biopsy included evaluation for the nephrotic syndrome, asymptomatic proteinuria, hematuria/proteinuria, isolated hematuria or systemic disease. Fifty-one percent of the patients were white and 44 percent were black. The male/female ratio was 3.2:1. The most common etiology of the nephrotic syndrome or asymptomatic proteinuria was focal glomerular sclerosis, and was found predominantly in black males. IgA nephropathy was the most common cause of combined hematuria and proteinuria, and was not found in any black patients in 126 biopsies. Isolated hematuria was secondary to either IgA nephropathy or thin basement membrane disease in 70 percent of the biopsies. This is the first study to demonstrate such differences in glomerular disease in an American population on the basis of race and sex in a single center.