Saudi Journal of Kidney Diseases and Transplantation

LETTER TO EDITOR
Year
: 2001  |  Volume : 12  |  Issue : 1  |  Page : 54--55

The Pattern of Glomerular Diseases among Adults in the Southern Region of Saudi Arabia


Mohammad Al-Homrany 
 Consultant Nephrologist, College of Medicine and Medical Sciences, King Khalid University, P.O. Box 641, Abha, Saudi Arabia

Correspondence Address:
Mohammad Al-Homrany
Consultant Nephrologist, College of Medicine and Medical Sciences, King Khalid University, P.O. Box 641, Abha
Saudi Arabia




How to cite this article:
Al-Homrany M. The Pattern of Glomerular Diseases among Adults in the Southern Region of Saudi Arabia.Saudi J Kidney Dis Transpl 2001;12:54-55


How to cite this URL:
Al-Homrany M. The Pattern of Glomerular Diseases among Adults in the Southern Region of Saudi Arabia. Saudi J Kidney Dis Transpl [serial online] 2001 [cited 2020 Jul 13 ];12:54-55
Available from: http://www.sjkdt.org/text.asp?2001/12/1/54/33887


Full Text

To the Editor:

I read with great interest the special issue on glomerular diseases published in September, 2000.1 would like to share with you and the readers my view and our experience in the Asir region of Saudi Arabia, which has been recently published. [1] We have reported the histological findings of 166 kidney biopsies performed in adult patients. All biopsies were processed for light microscopy (LM), immunofluorescence (IF), and electron microscopy (EM). Eighty-two percent of the patients were Saudis and all of them were residents of the region. The indications for kidney biopsy were similar to the three studies published earlier. [2],[4] Our data showed that the most common histological lesion was mesangio­capillary glomerulonephritis (MCGN), which accounted for 25.9% of all the cases and 38.7% of the primary glomeruloneph­ritides. This was followed by immuno­globulin A nephropathy (IgA'N) in 12.7%, focal and segmental glomerulosclerosis (FSGS) in 11.4%, minimal change disease and membranous nephropathy in 6.6% each. It is unfortunate that our report was not quoted in any of the studies published in this issue. [4] Both Huraib et al and Mitwalli et al quoted the report of Jorgenson et al [5] as representative to the pattern of glomerular disease in the Southern region of Saudi Arabia. In the report of Jorgenson et al, the commonest renal lesion was mesangio­proliferative GN. This report was published in the mid-eighties as a letter to the editor with very small number of patients (28, of whom one patient had FSGS and one other had MCGN) and immunofluorescence studies were not done. We believe that our data reflects the pattern of glomerular disease in the southern region better. Our data showed high prevalence of MCGN (25.9%) as well as IgAN (12.7%), higher than reported by Huraib [2] and Mitwalli et al, [3] and close to the report by Mousa et al. [4] I believe that the discrepancy between all these reports might be related to the patient selection criteria for kidney biopsy. Genetic, familial and environmental factors are associated with different forms of glomerular diseases. These factors may lead to variations of the pattern in different regions of Saudi Arabia. Infectious diseases such as hepatitis B, C and in particular, schistosomiasis are common health problems in the southern region of Saudi Arabia. [6] Indeed, MCGN is known to be associated with these tropical diseases. The prevalence of hepatitis B surface antigen (HBsAg) and hepatitis C antibody in the general population was 1.8%, while schistosomiasis was found in 4.2% of all cases and in 11.6% of MCGN patients. This may contribute to the high prevalence of MCGN in our population.

Both Huraib et al, and Mitwalli et al, have suggested that the pattern of glomerular disease is changing with time. This might be true in urban areas where the incidence of infectious diseases such as schisto­somiasis is decreasing, but I believe it is not so in rural areas.

I feel that the Saudi Registry of Glomerular Disease need to continue observing the patterns in the different centers in different regions, in order to provide a better understanding of the regional variations.

References

1Al-Homrany M. Pattern of renal diseases among adults in Saudi Arabia. A clinico­pathologic study. Ethnicity & Disease 1999;9:463-7.
2Huraib S, Al Khader A, Shaheen FAM, et al. The spectrum of glomerulonephritis in Saudi Arabia. The results of the Saudi Registry. Saudi J Kidney Dis Transplant 2000;ll(3):434-41.
3Mitwalli A, Al-Wakeel J, Abu-Aisha H, et al. Prevalence of glomerular disease: King Khalid University Hospital, Saudi Arabia. Saudi J Kidney Dis Transplant 2000; 11(3): 447-8.
4Mousa D, Al-Hawas F, Al-Sulaiman M, Al-Khader A. A prospective study of renal biopsies performed over one-year at the Riyadh Armed Forces Hospital. Saudi J Kidney Dis Transplant 2000; 11(3):449-54.
5Jorgenson H, Malik SH, Paul TT, Whom PC. Renal Disease in Saudi Arabia. Ann Saudi Med 1985;5:195.
6Al-Madani A. Problem in the control of schistosomiasis in Asir province, Saudi Arabia. J Common Health 1991 ;16(3): 143-9.