A Clinicopathologic Study of Glomerular Disease: Experience of the King Fahd Hospital of the University, Eastern Province, Saudi Arabia

Published studies from different centers in Saudi Arabia have reported contradicting results regarding glomerular lesions. In this retrospective study, we report our experience in King Fahd Hospital of the University at Al-Khobar in the Eastern province, including a description of the morphologic and clinical characteristics of primary and secondary glomerular disease. The study included 233 renal biopsies obtained from patients presenting with glomerular manifestations over a period of 23 years (1986–2008), investigated by light microscopy, immunofluorescence (149 cases) and electron microscopy (34 cases). One hundred and eighty-seven cases (80.3%) were primary glomerulonephritides. Minimal change glomerulopathy was the most common type of primary glomerulonephritis found (29.4% of primary glomerulonephritides), followed by mesangioproliferative glomerulonephritis (19.8%), and focal/segmental glomerulosclerosis (15.5%). Membranoproliferative glomerulonephritis was found in 9.6% of cases, membranous glomerulopathy in 8.6%, IgA nephropathy in 6.4%, end-stage glomerulopathy in 5.9%, crescentic glomerulonephritis in 3.2%, and IgM nephropathy in 1.6%. Of the secondary glomerulonephritides (46 cases constituting 19.7% of the biopsies), lupus nephritis was the most frequently diagnosed disease (71.7% of secondary glomerulonephritides). Diabetic glomerulosclerosis was found in 10.9% of cases, amyloidosis in 6.5%, and Alport syndrome in 4.3%. Wegener's granulomatosis, Henoch-Schönlein purpura nephritis and hypertensive nephrosclerosis each represented 2.2% of cases (one case each). Other than a significantly higher incidence of minimal change glomerulopathy and lupus nephritis (p < 0.001) and a significantly lower prevalence of membranoproliferative glomerulonephritis (p = 0.029), our results are generally comparable to those reported by the Saudi registry for glomerulopathy and in some neighboring countries. Ageand sex-adjusted analyses revealed that minimal change glomerulopathy and lupus nephritis were also the most prevalent primary and secondary glomerulopathies in the pediatric age group (below 15 years) as well as in adults, females and males.