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Title Epidemiology of Glomerular Diseases in Southeast Asia: The GN-SPECIAL (GlomeruloNephritis – Singapore-Philippines Epidemiology Cohorts In AduLts) Study |
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Type Oral Presentation |
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Theme 18th Asian Colloquium in Nephrology (18th ACN 2019) |
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Topic Chronic Kidney Disease: Epidemiology, Outcomes, Special Populations |
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Main Author Dr Zi Kheng Tan1 |
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Presenting Author Dr Zi Kheng Tan1 |
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Co-Author Dr Yeo See Cheng1 Lim Ru Sin 1 Dr Adrian Liew1 Dr Marc Angelo P. Hizon2 Dr Anthony Russell T. Villanueva2 |
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Department / Institution / Country Renal medicine / Tan Tock Seng Hospital / Singapore1 Department of Adult Nephrology / National Kidney and Transplant Institute / Philippines2 |
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Abstract Content: Introduction, Method, Result, Conclusion Introduction Glomerulonephritides (GN) remain a leading cause of end-stage kidney disease worldwide. Studies examining epidemiological trends and clinical differences in GN are lacking. We aim to evaluate the epidemiology, demographic trends and clinical features of renal histopathological frequencies in Singapore and the Philippines.
Methods We performed a cross-sectional study, described and compared the frequency and clinical feature of each GN diagnosis in patients (older than 16 years old) with kidney biopsies performed at the National Kidney and Transplant Institute, Philippines (2006-2015) and Tan Tock Seng Hospital, Singapore (2002-2016).
Results 5158 patients are included in the study, of which 4163 are from the Philippines and 995 are from Singapore. Gender distribution is similar between both countries (Males: 44% vs 46%), with younger patients seen in the Philippines [mean age 36.7±13.7 years vs 46.7±17.5 years (p<0.001)]. In the Philippines, the three most common glomerular diseases are IgA Nephropathy (IgAN) (34.4%); focal segmental glomerulosclerosis (FSGS) (16.0%) followed by lupus nephritis (LN) (9.9%). Whereas, in Singapore, these were LN (20.4%); IgAN (17.2%) followed by diabetic glomerulosclerosis (DG) (10.9%). IgAN is more prevalent in patients from the Philippines (34.4% vs 17.3%, p<0.001), LN is more common in patients from Singapore (20.5% vs 9.9%, p<0.001). Interestingly, biopsy-proven DG is more common in Singapore (10.9% vs 2.0%, p<0.001) and infection-related glomerulonephritis (IRGN) is similar in frequency in both countries (Philippines 0.6% vs Singapore 0.7%, p=0.72).
Conclusion In this study involving two large-scale renal biopsy cohorts, we identified significant epidemiological differences on the distribution of GN in Philippines and Singapore. Patients with IgAN and LN have worse renal function at presentation in Singapore and the Philippines respectively. The differences in DG may reflect biopsy practices and healthcare resourcing disparities. Despite socioeconomics and healthcare infrastructure differences in both countries, the incidence of biopsy-proven IRGN appear to be similar.
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