FREQUENCY OF GLOMERULAR DISEASES IN A HISTOPATHOLOGY CENTER IN LA PAZ BOLIVIA

The incidence of glomerular diseases varies according to geographic regions, with epidemiological information being scarce, particularly in Bolivia. For example, focal segmental glomerulosclerosis (FSGS) and diabetic glomerulosclerosis (GS) predominated in the US, followed by IgA nephropathy (IgAN; 12%), membranous nephropathy (12%), and lupus nephritis. (10%). FSGS was also common in Latin America (16%), although lupus nephritis strongly predominated in this region (38%). In Bolivia, although the population may be ethnically similar to Mexico and Peru, a database of kidney biopsies has not been compiled due to cost or lack of trained personnel. The objective of the study was to determine the frequency of glomerular diseases and their clinical correlation.

We carried out an observational, retrospective, descriptive, quantitative and cross-sectional study of kidney biopsies from a private center in the city of La Paz Bolivia between the years 2017 to 2021. Patients over 18 years of age were included with optical microscopy and immunofluorescence for IgG, IgA, IgM, C3, C1q, kappa, lambda, fibrinogen in native kidneys. The exclusion criteria were those with incomplete data to date, biopsies sent for study from other departments of the country, and transplant recipients. The analysis was carried out with the statistical package SPSS Version 15.0. We used a Pearson chi-square test to investigate the association of categorical variables, a p value <0.05 was considered significant.

La edad promedio fue de 42,49 años y en el 44% de los pacientes el grupo de edad estuvo entre 30-59 años. El sexo femenino fue 52,7% más frecuente, la creatinina sérica promedio fue de 2,12 mg/dl, la proteinuria promedio fue de 5,2 g/d. El 63,6% reportó sedimento activo, para microscopía óptica se identificaron un promedio de 10,62 glomérulos y para inmunofluorescencia 7,7.

De los pacientes con GNPR que requirieron hemodiálisis alcanza el 8,35%. La forma de presentación más frecuente fue síndrome nefrótico en 37,7%, seguido de proteinuria no nefrótica 12,1%, hematuria con deterioro de la función renal 8,8%, síndrome nefrítico 6,1%, proteinuria hematuria: 4,5%.

Las glomerulopatías diagnosticadas son nefropatía lúpica en 22,3%, ANCA: 5,2%, GNM: 17,3, GNIgA: 17,5%, GEFyS: 4,1%, GNPI: 1,1%, MPGN: 5,8, otras: 26,6%.

En menores de 30 años y entre 30 y 59 años la GN más frecuente fue el lupus, entre 30 y 59 años la segunda GN más común es la GNM y en mayores de 60 años la GNM.

The research carried out determines that the most frequent glomerulopathies diagnosed by renal biopsy in native kidneys in a histopathological study center in La Paz Bolivia was lupus nephropathy, followed by GNIgA and GNM, the most frequent age of presentation of these pathologies is between 30-45 years and the indication for renal biopsy varies according to the type of glomerulopathy to be studied, however, nephrotic syndrome was the most frequent.