PATTERNS OF GLOMERULAR DISEASES AT AIN SHAMS UNIVERSITY HOSPITALS: A 10-YEAR REVIEW OF RENAL BIOPSY DATA

 

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https://storage.unitedwebnetwork.com/files/1099/1b1fe833ab5077ef0cb719d8d8b5f08a.pdf
PATTERNS OF GLOMERULAR DISEASES AT AIN SHAMS UNIVERSITY HOSPITALS: A 10-YEAR REVIEW OF RENAL BIOPSY DATA

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Ahmed
Emara
Mahmoud Zaki mmzakiali@hotmail.com Ain Shams university nephrology Cairo Egypt -
Hayam Hebah hheibah@med.asu.edu.eg Ain Shams university nephrology Cairo Egypt -
Waleed Abdelmohssen Waleed_abdelmohsen@med.asu.edu.eg Ain Shams university nephrology Cairo Egypt -
Abdelbasset Alshaarawy shaarawy_abassit@yahoo.com Ain Shams university nephrology Cairo Egypt -
Ahmed Emara ahmed_emara@med.asu.edu.eg Ain Shams university nephrology Cairo Egypt *
 
 
 
 
 
 
 
 
 
 

Glomerular diseases are a major cause of chronic kidney failure, accounting for approximately 20–25% of cases worldwide, particularly affecting younger populations. This study aimed to characterize the spectrum and distribution of glomerular diseases diagnosed at Ain Shams University Hospitals over a 10-year period (2009–2018).

This retrospective observational study included all renal biopsies processed at our institution between 2009 and 2018. Each specimen was examined using light microscopy, immunofluorescence, and, when indicated, electron microscopy. Diagnoses were categorized as primary glomerular diseases (1ry GDs), secondary glomerular diseases (2ry GDs), or tubulointerstitial diseases (TIDs) according to standard histopathological criteria. Demographic, clinical, and laboratory data were analyzed alongside biopsy findings.

A total of 999 renal biopsies were reviewed. Primary GDs were identified in 453 patients (45.3%), secondary GDs in 478 (47.8%), and TIDs in 68 (6.8%).
The cohort included 292 patients aged <18 years (29.3%), 375 aged 18–40 years (37.7%), and 329 aged >40 years (33%).

Among 1ry GDs, membranous nephropathy was the most frequent diagnosis, followed by immune complex–mediated membranoproliferative glomerulonephritis (MPGN), IgA nephropathy, minimal change disease, and primary focal segmental glomerulosclerosis (FSGS).
Among 2ry GDs, lupus nephritis predominated, followed by secondary FSGS, post-infectious glomerulonephritis, diabetic nephropathy, and cryoglobulinemic GN.
Within the TID group, chronic tubulointerstitial nephritis (TIN) was most common, followed by acute TIN and acute tubular necrosis.

Age-stratified analysis showed that in patients <18 years, minimal change disease was the most frequent 1ry GD, lupus nephritis was the leading 2ry GD, and chronic TIN was the predominant TID.
In patients aged 18–40 years, membranous nephropathy and lupus nephritis remained the most common 1ry and 2ry GDs, respectively, while chronic TIN persisted as the most frequent TID.
Among those aged >40 years, a similar pattern was observed.




overall diagnoses in the study biopsies.


Primary Glomerular diseases in the study.


Secondary Glomerular diseases in the study.


Tubulointerstitial diseases in the study


Diagnosis by Age categories in the study.


In this 10-year renal biopsy review, both primary (1ry) and secondary (2ry) glomerular diseases (GDs) were frequently identified, with secondary forms slightly more prevalent.
Membranous nephropathy was the most common 1ry GD, while lupus nephritis predominated among 2ry GDs.

Chronic tubulointerstitial nephritis (TIN) was the leading tubulointerstitial lesion across all age groups.

Minimal change disease was the most frequent 1ry GD in patients younger than 18 years, whereas membranous nephropathy and lupus nephritis remained dominant in adult and middle-aged groups.

These findings underscore the ongoing burden of immune-mediated glomerulopathies in our region and reaffirm the pivotal role of renal biopsy in accurate diagnosis and management. Our results mirror current global trends and highlight the need for continued surveillance to monitor evolving disease patterns and guide national strategies for early detection and treatment.


Kewords