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Kidney disease is a leading global cause of morbidity and mortality, and this trend holds true in our country. It significantly affects patients' quality of life and places a substantial financial burden on healthcare systems. In Mexico, end-stage chronic kidney disease is among the top 10 leading causes of death. Globally, glomerular diseases are the leading cause of kidney disease. Characterizing the histology of affected kidneys is essential for pinpointing the exact causes and tailoring specific treatments. Having a strong grasp of epidemiological data helps us take effective steps in prevention and treatment. This study aims to describe the histopathological types and sociodemographic characteristics of patients with glomerulopathies at the Hospital General de Occidente.
A descriptive cross-sectional study was conducted from 1994 to 2018, involving patients over 18 years old with glomerulopathies who had undergone renal biopsies and were evaluated at the Nephrology Department of the Hospital General de Occidente.
A total of 260 patients were included in the study, and their data were used for statistical analysis. The mean age for the entire sample was 30.3 years, with a standard deviation of 16.9 years. Females made up the majority, accounting for 59.6% of the patients (n=155), while males represented 40.4% of the sample (n=105) (graphic 1).
The most common place of origin was Guadalajara at 22.7% (n=59), followed by Zapopan at 21.2% (n=55), and Tlaquepaque at 4.2% (n=11). The most prevalent glomerulopathy was membranoproliferative, accounting for 34.2% of the sample (n=89), followed by focal and segmental with 32.7% (n=85).
Patients who presented with membranoproliferative glomerulopathy were younger (mean=24.6 years) compared to those who did not have this type (mean=33.4 years). There were no differences between this type of glomerulopathy and gender (p=0.415) or place of origin (p=0.377).
Regarding the focal and segmental glomerulopathy. No statistically significant differences were found between this type of glomerulopathy and gender (p=0.471) or place of origin (p=0.488). There were also no differences in terms of age (p=0.881).
The mean age of 30.2 years, with a standard deviation of 16.9 years, suggests that this procedure is more common among young adult patients, consistent with other studies conducted in the country. Timely diagnosis and specific treatment are vital to halt disease progression, positively impacting life expectancy and quality of life for these patients.
Females predominated at 59.6% compared to males at 40.4%. This might be influenced by autoimmune etiologies as a presentation of glomerular disease, which tends to be more prevalent in females.
We found that membranoproliferative glomerulonephritis was the most prevalent with 34.2%, surpassing other glomerulonephritis such as focal and segmental, membranous, and IgA. Furthermore, it is statistically more frequent in younger patients, with a mean age of 24.6 years, compared to the rest with a mean age of 33.4 years.
Identifying membranoproliferative glomerulonephritis as the most prevalent form in our study highlights the lack of research in our country regarding glomerulonephritis. One of our study's limitations is the absence of in-hospital infrastructure for renal biopsy interpretation, including the essential electron microscopy required for accurate membranoproliferative glomerulonephritis (MPGN) interpretation, which has not been, available in our region for more than 15 years. Additionally, the changes that have occurred over the years in terms of classification and other diagnostic criteria for this etiology, make these biopsy results questionable in retrospect. Many of them were attributed to the summaries sent about the patients for the interpretation of biopsies by nephropathologists. It is imperative to supplement our findings with electron microscopy and collaborate on a multicenter study to gain a better understanding of disease prevalence in our country.