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

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.