Evolution of chronic glomerular disease spectrum and epidemiological characteristics of membranous nephropathy

Objective To investigate the composition of chronic glomerular disease spectrum as well as the epidemiological characteristics of membranous nephropathy in Guangdong Provincial People's Hospital in recent 18 years. Methods Patients undergoing kidney biopsy in Guangdong Provincial People's Hospital from 1st January 2001 to 31st December 2018 were enrolled in this study. We analyzed the histopathological composition and evolution of chronic glomerular disease spectrum and explored the epidemiological characteristics of membranous nephropathy as well. Results A total of 6 366 cases of patients with renal biopsy were enrolled in this study. The cases number, average age and the percentage of males were increasing year by year. IgA nephropathy (47.9%), membranous nephropathy (27.8%), minimal change disease (13.4%), focal segmental glomerulosclerosis (8.0%) and membranoproliferative glomerulonephritis (1.7%) ranked the five commonest primary glomerular diseases. Lupus nephritis (40.7%), diabetic nephropathy (13.7%), hypertensive nephropathy (10.1%), hepatitis B related nephritis (9.5%) and Henoch-Schlein purpura nephritis (9.3%) were the five commonest secondary glomerular diseases. IgA nephropathy and lupus nephritis were the first commonest primary and secondary glomerular diseases, respectively. Membranous nephropathy and diabetic nephropathy were fastest increasing primary and secondary glomerular diseases, respectively. The proportion of membranous nephropathy complicated with hypertension, diabetes, hyperlipidemia and hyperuricemia was increasing year by year. The prevalence of membranous nephropathy in patients performed renal biopsy with hypertension, diabetes and hyperuricemia was higher than the prevalence of membranous nephropathy in renal-biopsy patients without complicated hypertension, diabetes and hyperuricemia. The difference had statistical significance (P<0.05). Conclusions Primary glomerular diseases remain the predominant kidney diseases in renal biopsy cases. IgA nephropathy and lupus nephritis are the commonest primary glomerular diseases and secondary glomerular diseases respectively. The incidence of membranous nephropathy and diabetic nephropathy has been increasing significantly in recent year. High prevalence of membranous nephropathy may be associated with an increased incidence of metabolic diseases.