A Global Evolutionary Trend of the Frequency of Primary Glomerulonephritis over the Past Four Decades

Introduction: The pattern of glomerulonephritis in Singapore is compared with that of 19 other countries to review changing trends in the evolution of glomerulonephritis in Asian, Eastern and Western countries.

Method: 3289 renal biopsies in Singapore were reviewed and compared with that of 19 other countries.

Results: IgA nephritis is on the decline in many countries, including Singapore, though it still remains the commonest Glomerulonephritis in Singapore. Membranous Glomerulonephritis which used to be more frequently present in Western countries has also declined though it continues a rising trend in countries like Singapore and China. Worldwide, the frequency of  Focal Sclerosing Glomerulosclerosis (FSGS) continues to increase in many countries but in some countries the frequency is still low with Mesangiocapillary Glomerulonephritis  remaining  indigenous.

Conclusion: Urbanization and socio-economic changes and less exposure to parasitic and other infestations have transformed Singapore’s   pattern which is tending towards that of more developed countries.  Antigenic exposure   due to lifestyle changes, environmental and industrial pollution are significant contributory factors which affect the evolutionary trend of glomerulonephritis in many countries. The rising trend in the frequency of FSGS may reflect aging and obesity.