Hong Kong Journal of Nephrology
Volume 12, Issue 1 , Pages 20-30, April 2010

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

  • Mohamed Shawarby

      Affiliations

    • Department of Pathology, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Dalal Al Tamimi

      Affiliations

    • Department of Pathology, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Sameer Al Mueilo

      Affiliations

    • Department of Internal Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Ibrahim Saeed

      Affiliations

    • Department of Internal Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
    • Corresponding Author InformationCorrespondence to: Dr. Ibrahim Saeed, Department of Internal Medicine, King Fahd Hospital of the University, King Faisal University, Al-Khobar 31952, Saudi Arabia
  • ,
  • Abdulla Hwiesh

      Affiliations

    • Department of Internal Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Fahd Al-Muhanna

      Affiliations

    • Department of Internal Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Suliman Al Mohaya

      Affiliations

    • Department of Internal Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Saleh Al-Sowayan

      Affiliations

    • Department of Pathology, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Adel Montasser

      Affiliations

    • Department of Pathology, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Tarek Hashem

      Affiliations

    • Department of Pathology, College of Medicine, King Faisal University, Dammam, Saudi Arabia
  • ,
  • Ammar H. Khamis

      Affiliations

    • Department of Family and Community Medicine, College of Medicine, King Faisal University, Dammam, Saudi Arabia

Article Outline

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.

Key words:  crescentic glomerulonephritis , glomerulonephritis , glomerulopathies , primary glomerulonephritis

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Churg J , Sobin LH . In: Renal Disease: Classification and Atlas of Glomerular Diseases . 2nd edition. Tokyo: Igaku-Shoin; 1995;p. 151–180
  2. Huraib S , Al Khader A , Shaheen FA , Abu Aisha H , Souqiyyeh MZ , Al Mohana F , et al.   The spectrum of glomerulonephritis in Saudi Arabia: the results of the Saudi registry . Saudi J Kidney Dis Transpl . 2000;11:434–441
  3. Alkhunaizi AM . Pattern of renal pathology among renal biopsy specimens in Eastern Saudi Arabia . Saudi Med J . 2007;28:1676–1681
  4. Bernieh B , Sirwal IA , Abbadi MA , Ashfaquddin M , Mohammad AO . The spectrum of glomerulonephritis in adults in Madinah Munawarah region . Saudi J Kidney Dis Transpl . 2000;11:455–460
  5. Mousa DH , Al-Hawas FA , Al-Sulaiman MH , Al-Khader AA . A prospective study of renal biopsies performed over one-year at the Riyadh Armed Forces Hospital . Saudi J Kidney Dis Transpl . 2000;11:449–454
  6. Mitwalli AH , Al Wakeel J , Abu-Aisha H , Alam A , Al Sohaibani M , Tarif N , et al.   Prevalence of glomerular diseases: King Khalid University Hospital, Saudi Arabia . Saudi J Kidney Dis Transpl . 2000;11:442–448
  7. Al-Homrany M . The pattern of glomerular diseases among adults in the Southern Region of Saudi Arabia . Saudi J Kidney Dis Transpl . 2001;12:54–55
  8. Akhtar M , Qunibi W , Taher S , Ginn E , Furayh O , Sanjad S , et al.   Spectrum of renal disease in Saudi Arabia . Ann Saudi Med . 1990;10:37–44
  9. Huraib SO , Abu-Aisha H , Mitwalli A , Mahmoud K , Memon NA , Sulimani F . The spectrum of renal disease found by kidney biopsies at King Khalid University Hospital . Saudi Kidney Dis Transplant Bull . 1990;1:15–19
  10. Narasimhan B , Chacko B , John GT , Korula A , Kirubakaran MG , Jacob CK . Characterization of kidney lesions in Indian adults: towards a renal biopsy registry . J Nephrol . 2006;19:205–210
  11. Al Arrayed A , George SM , Malik AK , Al Arrayed S , Rajagopalan S , Al Arrayed A , et al.   The spectrum of glomerular diseases in the Kingdom of Bahrain: an epidemiological study based on renal biopsy interpretation . Transplant Proc . 2004;36:1792–1795
  12. Rychlík I , Jancová E , Tesar V , Kolsky A , Lácha J , Stejskal J , et al.   The Czech registry of renal biopsies. Occurrence of renal diseases in the years 1994–2000 . Nephrol Dial Transplant . 2004;19:3040–3049
  13. Shaker IK , Al-Saedi AJ , Al-Salam S , Saleem MS , Al-Shamma IA . Spectrum of glomerular disease in Iraqi patients from a single center . Saudi J Kidney Dis Transpl . 2002;13:515–519
  14. Barsoum RS , Francis MR . Spectrum of glomerulonephritis in Egypt . Saudi J Kidney Dis Transpl . 2000;11:421–429
  15. Said R , Hamzeh Y , Tarawneh M . The spectrum of glomerulopathy in Jordan . Saudi J Kidney Dis Transpl . 2000;11:430–433
  16. Chan KW , Chan TM , Cheng IKP . Clinical and pathological characteristics of glomerular diseases at a university teaching hospital. A 5-year prospective review . HK Med J . 1999;5:240–244
  17. Stratta P , Segoloni GP , Canavese C , Sandri L , Mazzucco G , Roccatello D , et al.   Incidence of biopsy-proven primary glomerulonephritis in an Italian province . Am J Kidney Dis . 1996;27:631–639
  18. Dash S , Al Muhanna FA . Unresolved issues in glomerulonephritis . Ann Saudi Med . 2005;25:329–334

PII: S1561-5413(10)60005-1

doi:10.1016/S1561-5413(10)60005-1

Hong Kong Journal of Nephrology
Volume 12, Issue 1 , Pages 20-30, April 2010