Introduction:
Glomerular diseases (GD) are a group of immune mediated or genetic diseases that involve the filtering units, or glomeruli of the kidneys. Using centralized provincial kidney pathology records and census data, we aim to find geographic patterns, measure incidence rates, and understand rural/urban differences of GD.
Methods:
We conducted an epidemiological study on adult patients who underwent kidney biopsies in Saskatchewan, Canada from 2002-2018. We collected and analyzed demographic characteristics, 3-digit postal codes, laboratory parameters, biopsy dates, GD diagnosis, dialysis initiation dates, and mortality data. We examined the incidence of primary GD, and the proportion of cases that underwent dialysis or resulted in mortality. Regional variation in GD were analyzed using SaTScan v10.1.3 software. The study received approval by the provincial research and ethics board.
Results:
1372/3,509 renal biopsies met the inclusion criteria. GD incidence increased from 4.6 to 13.6 per 100,000 persons from 2002 to 2018 (p<0.00001). GD incidence was higher in rural areas than in urban areas (10.73 vs. 8.92 per 100,000 per year, p-0.0005). Significantly higher dialysis progression rates were seen for rural and remote areas (p-0.004). A geospatial cluster of 345.7 km2 was identified for lupus nephropathy (LN) with an incident rate ratio of 1.73, a relative risk of 2.7, and a Log likelihood ratio of 13.87. No significant clusters were identified for any other subtypes of GD.
Conclusions:
Our study provides valuable insights into geographic clustering, rural-urban divide, rates of progression to dialysis, and death in all histological subtypes. We identified a geographic cluster for LN encompassing rural and urban areas. Patients in rural and remote areas had a higher proportion of cases progressing to dialysis, while urban areas had higher mortality. Addressing and understanding the multifaceted factors driving these disparities are essential steps toward easing the burden of GD on impacted communities.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.