Incidence of glomerulonephritis and non-diabetic end-stage renal disease in a developing middle-east region near armed conflict.

Abstract:

BACKGROUND:Estimates of the incidence of glomerulonephritis (GN) and end-stage renal disease (ESRD) in an Iraqi population are compared with the United States (US) and Jordan. METHODS:The study set consist of renal biopsies performed in 2012 and 2013 in the Kurdish provinces of Northern Iraq. The age specific and age standardized incidence of GN was calculated from the 2011 population. ESRD incidence was estimated from Sulaimaniyah dialysis center records of patient's inititating hemodialysis in 2017. RESULTS:At an annual biopsy rate of 7.8 per 100,000 persons in the Kurdish region, the number of diagnoses (2 years), the average age of diagnosis, and annual age standardized incidence (ASI)/100,000 for focal segmental glomerulosclerosis (FSGS) was n = 135, 27.3 ± 17.6 years, ASI = 1.6; and for all glomerulonephritis (GN) was n = 384, 30.4 ± 17.0 years, ASI = 5.1. FSGS represented 35% of GN biopsies, membranous glomerulonephritis 18%, systemic lupus erythematosus 13%, and immunoglobulin A nephropathy 7%. For FSGS and all GN, the peak age of diagnoses was 35-44 years of age with age specific rates declining after age 45. The unadjusted annual ESRD rate was 60 per million with an age specific peak at 55-64 years and a decline after age 65. The assigned cause of ESRD was 23% diabetes, 18% hypertension, and 12% GN with FSGS comprising 41% of biopsy-diagnosed, non-diabetic ESRD. CONCLUSIONS:The regional incidence of ESRD in Northern Iraq is much lower than the crude incidences of 100 and 390 per million for Jordan and the US respectively. This is associated with low renal disease rates in the Iraqi elderly and an apparent major contribution of FSGS to ESRD.

journal_name

BMC Nephrol

journal_title

BMC nephrology

authors

Ali AA,Sharif DA,Almukhtar SE,Abd KH,Saleem ZSM,Hughson MD

doi

10.1186/s12882-018-1062-7

subject

Has Abstract

pub_date

2018-10-11 00:00:00

pages

257

issue

1

issn

1471-2369

pii

10.1186/s12882-018-1062-7

journal_volume

19

pub_type

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