Dr Breanna Hollow1, Dr Ashley Irish1, Dr Ramyasuda Swaminathan1, Ms Sharon Ho1, Dr Harish Puttagunta1
1Fiona Stanley Hospital, Murdoch , Australia
Biography:
Dr Breanna Hollow is a third-year Basic Physician Trainee based at Fiona Stanley Hospital in Perth, Western Australia. She has a special interest in nephrology and hopes to pursue a career in this field.
Aim:
To examine the epidemiology of biopsy-proven glomerulonephritis (GN) at a tertiary nephrology centre in Western Australia between January 2015 and November 2024.
Background:
Changing patterns of GN have been postulated in the context of our population’s changing metabolic profile. However, there is limited contemporary data pertaining to the patterns of biopsy-confirmed GN in Australia.
Methods:
All reports of adult native renal biopsies performed between January 2015 and November 2024 at a tertiary nephrology centre In Western Australia were reviewed. Biopsies of individuals under 18 years and repeat biopsies on the same individual were excluded. Primary biopsy diagnoses were categorised into major histopathological groups.
Results:
During the study period 1146/2420 (47.3%) of renal biopsies confirmed glomerulonephritis. The most common GN identified was IgA nephropathy (n=333; 29.1%), followed by focal segmental glomerulosclerosis (FSGS) (n=229; 20.0%), membranous GN (n= 143; 12.5%) and lupus nephritis (n= 118; 10.3%). Of the membranous GN cases with known circulating PLA2R antibody status (n=64), the majority were antibody negative (n=41; 64.1%). In patients with secondary FSGS (n=46), 71.7% (n= 33) were considered obesity-related.
Conclusions:
The distribution of biopsy-confirmed glomerulonephritis in our study was similar to that observed in historic Australian studies. IgA nephropathy continues to be the most common biopsy diagnosis, followed by FSGS. The increased proportion of PLA2R negative versus antibody positive membranous GN could reflect reduced use of biopsy in this diagnosis since PLA2R antibody testing has become widely available. Although most secondary FSGS cases were linked to obesity in our cohort, further studies are required to ascertain the incidence of obesity-related FSGS at a population level.