Patterns of renal disease in Cape Town South Africa: a 10-year review of a single-centre renal biopsy database.
BACKGROUND
The patterns of glomerular diseases have been widely reported from different regional and national biopsy registries worldwide. However, there are scant studies on the epidemiology of biopsy-proven renal disease, particularly glomerular diseases in sub-Saharan Africa.


METHODS
We retrospectively analysed the reports of 1284 native renal biopsies, reviewed by the same pathologist and performed at the Groote Schuur Hospital in Cape Town from 1 January 2000 to 31 December 2009.


RESULTS
The mean age of all the patients biopsied was 36.8 ± 14.0 years with 61.8% of the patients being under 40 years of age. There was a preponderance of females (54.8%). There were more coloured patients (53.7%) than blacks (42.2%) or whites (3.9%). The frequencies of clinical indications for a renal biopsy were nephrotic range proteinuria (52.5%), acute renal failure (21.3%), asymptomatic urinary abnormalities (13.6%), chronic renal failure (6.4%), acute nephritic syndrome (5.8%) and haematuria (0.3%). The frequencies of the primary glomerulonephritis (GN) include mesangiocapillary GN (20.4%), mesangial proliferative GN (19.2%), membranous GN (18.5%), crescentic and necrotizing GN (11.4%), focal and segmental glomerulosclerosis (10.5%), post-infectious GN (8.2%), minimal change disease (6.0%) and IgA nephropathy (5.8%). Lupus nephritis was the most frequent secondary glomerular disease (39.0%) and was also the most frequent cause of the nephrotic range proteinuria (17.2%). HIV-associated nephropathy increased from 6.6% in 2000 to 25.7% in 2009 (P < 0.0001).


CONCLUSIONS
Our data are an important contribution to the epidemiology of renal disease in Africa. We hope that this will form the basis for developing a renal biopsy registry in South Africa and across the continent.
Okpechi
Ikechi
I
Division of Nephrology and Hypertension, Groote Schuur Hospital and University of Cape Town, Observatory, 7925, Cape Town, South Africa. Ikechi.Okpechi@uct.ac.za
Swanepoel
Charles
C
Duffield
Maureen
M
Mahala
Bonginkosi
B
Wearne
Nicola
N
Alagbe
Stella
S
Barday
Zunaid
Z
Arendse
Craig
C
Rayner
Brian
B
D000328:Adult; D000367:Age Factors; D001706:Biopsy; D016208:Databases, Factual; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D013997:Time Factors