Mortality and renal outcome of primary glomerulonephritis in Korea: observation in 1,943 biopsied cases.
BACKGROUND
Previous epidemiological studies have focused on the prevalence of primary glomerulonephritis (GN), but few have explored long-term patient outcomes. This study was conducted to investigate the long-term patient and renal outcomes of primary GN.


METHODS
A total of 1,943 biopsy-proven primary GN patients were included. The outcomes were mortality and end-stage renal disease (ESRD) progression. The relative mortality rate was expressed by the standardized mortality ratio (SMR) and the 95% confidence interval (CI).


RESULTS
During the median follow-up of 90 months, 325 (16.7%) patients progressed to ESRD and 164 (8.4%) patients died. Patients with minimal change disease exhibited the best renal and patient outcomes, whereas those with membranoproliferative GN had the worst. IgA nephropathy patients appeared to have a good survival rate in spite of their considerable progression to ESRD, and focal segmental glomerulosclerosis patients showed poor renal and patient outcomes. Mortality was 67% higher in primary GN patients than in the age- and sex-matched general population (SMR, 1.67; 95% CI, 1.42-1.95). The difference was more prominent in women (SMR, 2.95; 95% CI, 2.27-3.77) than in men (SMR, 1.31; 95% CI, 1.07-1.60). Renal risk factors, e.g. hypertension, proteinuria and initial renal dysfunction, were all associated with higher mortality, and the relative mortality rate increased with the number of risk factors.


CONCLUSIONS
In patients with primary GN, mortality is significantly higher than in the age-/sex-matched general population, especially in women. Moreover, the presence of renal risk factors is positively associated with both relative mortality and progression to ESRD.
Department of Internal Medicine, Seoul National University Hospital, Seongnam, Republic of Korea.
Hajeong
H
Lee
Dong Ki
DK
Kim
Kook-Hwan
KH
Oh
Kwon Wook
KW
Joo
Yon Su
YS
Kim
Dong-Wan
DW
Chae
Suhnggwon
S
Kim
Ho Jun
HJ
Chin
D000328:Adult; D001706:Biopsy; D005260:Female; D005921:Glomerulonephritis / Q000150:complications / Q000401:mortality* / Q000473:pathology; D006801:Humans; D007668:Kidney / Q000473:pathology; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea / Q000453:epidemiology; D016019:Survival Analysis; D055815:Young Adult