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NDT Advance Access published online on March 4, 2009
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfp091
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Changing prevalence of glomerular diseases in Korean adults: a review of 20 years of experience

Jae Hyun Chang1,2*, Dong Ki Kim1,2*, Hyun Wook Kim1,2, Sun Young Park1,2, Tae-Hyun Yoo1,2, Beom Seok Kim1,2, Shin-Wook Kang1,2, Kyu Hun Choi1,2, Dae-Suk Han1,2, Heon Joo Jeong2,3 and Ho Yung Lee1,2

1 Department of Internal Medicine 2 The Institute of Kidney Disease 3 Department of Pathology, Yonsei University College of Medicine, Seoul, Korea

Correspondence and offprint requests to: Ho Yung Lee; E-mail: hyl{at}yuhs.ac



  Abstract

Background. The prevalence of glomerular diseases differs according to geographic area, race, age and indications for a renal biopsy. This study was conducted to evaluate the distribution and changing patterns of renal diseases during the past 20 years in a large patient population in Korea.

Methods. Patients aged 16 years or older who underwent a renal biopsy at Severance Hospital in the Yonsei University Health System from 1987 to 2006 were enrolled. All medical records were reviewed retrospectively.

Results. In total, 1818 patients (M:F = 1.02:1) were reviewed. Glomerulonephritis (GN) comprised 85.9% of the total biopsied cases. The most common primary GN was IgA nephropathy (IgAN) (28.3%), which was followed by minimal change disease (MCD) (15.5%), membranous nephropathy (MN) (12.3%), focal segmental glomerulosclerosis (FSGS) (5.6%) and membranoproliferative GN (MPGN) (4.0%). The most common secondary GN was lupus nephritis (8.7%). The most common idiopathic nephrotic syndrome was MCD (38.5%), which was followed by MN and IgAN. Among 128 (7.4%) patients who were HBsAg-positive, MN (30.5%) and MPGN (21.1%) were the most common GN. When the incidence rates between 1987–91 and 2002–06 were compared, IgAN increased from 25.6 to 34.5%, while MCD (from 23.2 to 7.0%) and MPGN (from 6.7 to 1.7%) decreased significantly (P < 0.01).

Conclusions. IgAN was the most common primary GN, and MCD was the most common cause of nephrotic syndrome. In the 5-year quartile comparison, the relative frequency of IgAN increased, while the relative frequency of MCD and MPGN decreased significantly during the past 20 years.

Keywords: adult; glomerulonephritis; nephrotic syndrome; prevalence; renal biopsy

* These authors contributed equally to this work.

Received for publication: 4. 7.08
Accepted in revised form: 12. 2.09


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