Clinical and pathological characteristics of patients with glomerular diseases at a university teaching hospital: 5-year prospective review

KW Chan, TM Chan, IKP Cheng
Department of Pathology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong

OBJECTIVE. To examine the prevalence of glomerular disease in Hong Kong.

DESIGN. Prospective review.

SETTING. University teaching hospital, Hong Kong.

PATIENTS. All patients who presented with suspected glomerular disease from 1993 through 1997.

MAIN OUTCOME MEASURES. Histopathological diagnosis from biopsy examination and clinical features of presentation.

RESULTS. A total of 1629 consecutive percutaneous renal biopsies of native kidneys showed glomerular disease in 1413 cases. The most common clinical indication for renal biopsy was persistent proteinuria (n=735; 52.0%), while the most frequently found glomerular lesion was immunoglobulin A nephropathy (n=338; 23.9%). Minimal-change nephrotic syndrome (n=125; 8.8%) and immunoglobulin M nephropathy (n=11; 0.8%), were the most common glomerular diseases that presented with nephrotic syndrome. The male to female ratio for lupus nephritis was 1:14 (n=290), whereas for minimal-change nephrotic syndrome, the ratio was 1.8:1 (n=125). Immunoglobulin A nephropathy and membranous glomerulonephritis (n=117) affected approximately equal numbers of male and female patients. Familial fibrillary glomerulonephritis, a disease hitherto unknown in Hong Kong, was diagnosed in two siblings.

CONCLUSION. Immunoglobulin A nephropathy was the most common glomerular disease in this survey and represents an important cause of end-stage renal failure in the Hong Kong population.

Hong Kong Med J 1999;5:240-4

Key words: Biopsy; Glomerulonephritis; Kidney diseases/pathology