VARIATION IN HISTOPATHOLOGICAL PATTERNS OF RENAL DISEASES IN EGYPT

The prevalence of chronic kidney disease (CKD) in dramatically increased in the past decades. Glomerular diseases are one of the leading causes of ESRD in Egypt and worldwide. Preventing CKD can significantly lessen the burden on governments and improve the public health. Consequently, it is crucial to effectively prevent and manage the etiologies of CKD. This retrospective study was conducted at the Department of Nephrology at the Damanhour medical national institute. In this study, we analyzed data from kidney biopsies performed in our center from January 2019 to October 2023 to investigate the changing spectrum of kidney diseases in El-Behira Governorate.

A total of 278 cases were reviewed at the Department of Nephrology, between January 2019, and October 2023. Clinical records were reviewed to collect clinical and laboratory information, including demographic information (age and sex) and other nephropathological diagnoses. All biopsies done by nephrologists using real-time ultrasound guided technique.

A total of 283 cases. The mean age was 38.6 ± 14.1. The male-to-female ratio was 1.05:1 (male, 51.2%).

1ry GN, 2ry GN, TIN, and other diagnoses accounted for 45.3%, 39.9%, 4.7%, and 10.1% of cases, respectively. The proportions of 1ry GN in different periods were 36.2.2% (2019), 40% (2020), 50% (2021), 49% (2022) , and 56.9% (2023); 2ry GN accounted for 44.9% (2019), 46.2% (2020) , 40.5% (2021) , 37.3% (2022), and 27.5% (2023); and TIN accounted for 6.7% (2019), 3.1% (2020) , 4.8% (2021) , 3.9% (2022), and 2% (2023)The proportion of PGN in different periods showed a growth trend, while the proportions of SGN declined. FSGS, MCD, and MN were the main causes of 1ry GN, accounting for 37.3%, 27.8%, and 20.6% of total 1ry GN patients, respectively. As shown in [Figure 1] , LN, vasculitis, and IRGN were the main causes of 2ry GN, accounting for 43.2%, 10.8% and 11.7%, respectively. From 2010 to 2018, the proportion of LN increased significantly (32.3% in 2019, 43.3% in 2020, 47.1% in 2021, 52.6% in 2022, and 50% in 2023).

FSGS, MCD, and MN were the main causes of 1ry GN in our study. The proportions of these types varied dramatically with age. FSGS mostly occurs in bimodal fashion as it occurred in 40.9% in 14-24 y age group and 83.3% in elderly patients group ≥ 60 y. meanwhile MN mostly occurred in young patients with a peak in the 25–44years age category (29.7%)

Overall, LN, vasculitis, IRGN were the most common 2ry GN diagnoses. The frequency of LN decrease dramatically with aging reached a peak (65.5%) in the 14–24 years age category and then dropped to 0% in ≥ 60 y. while IRGN frequency increased with age peaking in patients ≥ 60 y (50%).

FSGS is most common form of 1ry GN in our centre.

In elderly patient ≥ 60 y FSGS is the most common diagnosis of 1ry GN

LN is the most common diagnosis in young age group with 2ry GN

We still have a high incidence of IRGN especially in elderly group which known to have unfavorable outcomes.