Temporal and Demographic Trends in Glomerular Disease Epidemiology in the Southeastern United States, 1986–2015
Tóm tắt
Large-scale, contemporary studies exploring glomerular disease epidemiology in the United States are lacking. We aimed to determine 30-year temporal and demographic trends in renal biopsy glomerular disease diagnosis frequencies in the southeastern United States.
In this cross-sectional, observational study, we identified all patients with a native kidney biopsy specimen showing one of 18 widely recognized glomerular disease diagnoses referred to the University of North Carolina Chapel Hill Division of Nephropathology between 1986 and 2015. Biopsy era (1986–1995, 1996–2005, and 2006–2015) and demographics (age, sex, and race) were our primary and secondary predictors, respectively, and the relative frequency of each glomerular disease diagnosis was our primary outcome.
Among 21,374 patients (mean age =48.3±18.3 years old; 50.8% men; 56.8% white; 38.3% black; 2.8% Latino; 1.4% Asian; 0.8% other), the frequency of diabetic glomerulosclerosis in renal biopsy specimens increased dramatically over the three decades (5.5%, 11.4%, and 19.1% of diagnoses, respectively;
We identified significant changes in relative renal biopsy frequencies of many glomerular disease subtypes over three decades. Temporal trends were consistently observed within all major demographic groups, although relative predominance of individual glomerular disease subtypes differed according to patient age, sex, and race. We propose that exploration of behavioral and environmental exposures that likely underlie these findings should be the focus of future hypothesis-driven research.
Từ khóa
Tài liệu tham khảo
Genovese, 2010, Association of trypanolytic ApoL1 variants with kidney disease in African Americans., Science, 329, 841, 10.1126/science.1193032
Gharavi, 2011, Genome-wide association study identifies susceptibility loci for IgA nephropathy., Nat Genet, 43, 321, 10.1038/ng.787
Hurtado, 2005, Hygiene hypothesis and prevalence of glomerulonephritis., Kidney Int Suppl, 68, S62, 10.1111/j.1523-1755.2005.09711.x
McQuarrie, 2014, The incidence of biopsy-proven IgA nephropathy is associated with multiple socioeconomic deprivation., Kidney Int, 85, 198, 10.1038/ki.2013.329
Braden, 2000, Changing incidence of glomerular diseases in adults., Am J Kidney Dis, 35, 878, 10.1016/S0272-6386(00)70258-7
Dragovic, 2005, Increasing incidence of focal segmental glomerulosclerosis and an examination of demographic patterns., Clin Nephrol, 63, 1, 10.5414/CNP63001
Haas, 1997, Changing etiologies of unexplained adult nephrotic syndrome: A comparison of renal biopsy findings from 1976-1979 and 1995-1997., Am J Kidney Dis, 30, 621, 10.1016/S0272-6386(97)90485-6
Korbet, 1996, The racial prevalence of glomerular lesions in nephrotic adults., Am J Kidney Dis, 27, 647, 10.1016/S0272-6386(96)90098-0
Swaminathan, 2006, Changing incidence of glomerular disease in Olmsted County, Minnesota: A 30-year renal biopsy study., Clin J Am Soc Nephrol, 1, 483, 10.2215/CJN.00710805
Kraus, 2013, Resurgence of membranous nephropathy in African Americans in inner city Chicago., Clin Kidney J, 6, 373, 10.1093/ckj/sft057
Pontier, 1994, Racial differences in the prevalence and presentation of glomerular disease in adults., Clin Nephrol, 42, 79
Murugapandian, 2016, Epidemiology of glomerular disease in southern arizona: Review of 10-year renal biopsy data., Medicine (Baltimore), 95, e3633, 10.1097/MD.0000000000003633
D’Agati, 2004, Pathologic classification of focal segmental glomerulosclerosis: A working proposal., Am J Kidney Dis, 43, 368, 10.1053/j.ajkd.2003.10.024
Ehrenreich, 1968, Pathology of membranous nephropathy., Pathol Annu, 3, 145
Weening, 2004, The classification of glomerulonephritis in systemic lupus erythematosus revisited., Kidney Int, 65, 521, 10.1111/j.1523-1755.2004.00443.x
Servais, 2007, Primary glomerulonephritis with isolated C3 deposits: A new entity which shares common genetic risk factors with haemolytic uraemic syndrome., J Med Genet, 44, 193, 10.1136/jmg.2006.045328
2012, Increasing prevalence of diagnosed diabetes--United States and Puerto Rico, 1995-2010., MMWR Morb Mortal Wkly Rep, 61, 918
Sim, 2016, Distribution of biopsy-proven presumed primary glomerulonephropathies in 2000-2011 among a racially and ethnically diverse US population., Am J Kidney Dis, 68, 533, 10.1053/j.ajkd.2016.03.416
Nair, 2006, Is IgA nephropathy the commonest primary glomerulopathy among young adults in the USA?, Kidney Int, 69, 1455, 10.1038/sj.ki.5000292
Menke, 2015, Prevalence of and trends in diabetes among adults in the united states, 1988-2012., JAMA, 314, 1021, 10.1001/jama.2015.10029
Pham, 2007, Prevalence of nondiabetic renal disease in diabetic patients., Am J Nephrol, 27, 322, 10.1159/000102598
Feldman, 2013, Epidemiology and sociodemographics of systemic lupus erythematosus and lupus nephritis among US adults with Medicaid coverage, 2000-2004., Arthritis Rheum, 65, 753, 10.1002/art.37795
Tancredi, 2015, Excess mortality among persons with type 2 diabetes., N Engl J Med, 373, 1720, 10.1056/NEJMoa1504347