A research report submitted to the Faculty of Health Sciences,
University of the Witwatersrand, in fulfillment of the requirements for
the degree of Masters in Medicine (Internal Medicine)
Johannesburg 2017 / Background
Glomerular disease is a frequent and important cause of renal dysfunction. Current data on
the patterns of glomerular disease in South Africa is lacking. The aim of this study was to
characterize the prevalence and nature of presentation of primary glomerular disease at
Charlotte Maxeke Johannesburg Academic Hospital.
Materials And Methods
This single center, retrospective observational study was performed on adult native renal
biopsies over a 10 year period from 2001 - 2010. A total of 1495 native renal biopsies were
reviewed. After exclusion of common secondary causes, the results of 194 patients with
primary glomerular disease were evaluated.
Results
The most frequent primary glomerular disease was FSGS (29.8%) followed by MN (19.5%),
MPGN (18%), MCD (17%) and IgAN (3%). Nephrotic range proteinuria (60.5%) and
unexplained renal dysfunction (24.2%) were the most common indications for biopsy. There
was a 59.4% male predominance. From the 73.9 % of patients of African descent, 34.1%
presented with FSGS. The majority of patients (62.9%) were aged between 18-49 years with
30.3% of them presenting with FSGS. FSGS presented with a median creatinine 183.5 [101 -
476] mmol/l and mean UPCR (0.89 ± 0.66) g/mmol. There were no statistically significant
differences in albumin, haemoglobin and triglycerides between the glomerular disease
subtypes. The highest urine leucocytes and dysmorphic red cells were from the IgAN subtype.
Most patients, 56.8% had no casts observed, and 39.1% were hypertensive. No change in the
pattern of glomerular injury was observed over the course of the study.
Conclusion
Glomerular pathology is more common in younger patients. FSGS is more common than other
glomerular pathologies in our setting; which may partly be due to local biopsy practices and
patient demographics. Clinical parameters do not adequately predict biopsy findings. / MT2017
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/23291 |
| Date | January 2017 |
| Creators | Patchapen, Yvette |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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