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Objectives: To explore the epidemiological and histopathological patterns of glomerular
diseases in
Sabah .
Methods: A
state -wide
cross-sectional study was conducted. There were 336 native renal
biopsies in 296 eligible
patients from 1st January 2013 to 30th June 2016. All
patients aged ≥12 years with sufficient sampling (≥8 glomeruli) for histopathological assessment were included.
Graft kidney biopsies , protocol-based
biopsies and
patients with uncertain demographics were excluded. Demographics of
patients , clinical data,
laboratory parameters prior to
biopsy , and
histology findings of renal
biopsies were collected from local unit database and recorded into a standardised
data collection form. Descriptive statistical analyses were employed and factors associated with
Lupus nephritis (LN) were explored using
logistic regression .
Results: The mean age during
biopsy was 34.53 years (Standard Deviation 0.759). Primary
glomerulonephritis (PGN) accounted for 42.6% (126) of all native renal
biopsies . The commonest cause of PGN was
minimal change disease (38.9%, 49) followed by
focal segmental glomerulosclerosis (33.3%, 42) and
IgA nephropathy (14.3%, 18). LN is the leading cause for
secondary glomerulonephritis (SGN) (87.2%, 136). Younger age (
Odds Ratio , OR 0.978; 95%
Confidence Interval , 95%CI 0.960, 0.996);
female gender (OR 17.53; p<0.001); significant
proteinuria (OR 132.0; p<0.001);
creatinine level at
biopsy (OR 11.26; p=0.004); positive
antinuclear antibody (ANA) (OR 46.7; p<0.001); and ANA patterns (OR 8.038; p=0.018) were significant in predicting the odds of having LN.
Conclusion: This is the first
epidemiology study of glomerular
diseases in
Sabah . The predominance of LN suggests lower threshold for renal
biopsy in
patients with suspected glomerular disorders. We have identified significant predictors for early
detection and
treatment of LN