title: Geographical distribution, a risk factor for the incidence of lupus nephritis in China.
abstract: BACKGROUND
  Geographical variation in lupus nephritis epidemiology may indicate important environmental factors contributions to the etiology of lupus nephritis. This paper first describes the epidemiology of biopsy-proven lupus nephritis in China by performing a systematic literature review and the possible social-environmental influential factors.
  
  
  METHODS
  The keywords "lupus nephritis", "renal biopsy" and "systemic lupus erythematous" were searched in the three largest Chinese electronic databases and Medline/PubMed. The data of the patients with biopsy-proven lupus nephritis were extracted. The possible environmental influential factors including the population density, ethnic group populations, the ratio of females to males, the average sunshine per year, annual average temperature and annual relative humidity, in different regions of China were analyzed.
  
  
  RESULTS
  Forty-one study centers with 34574 renal disease patients, and 3699 lupus nephritis patients met the inclusion criteria. Lupus nephritis accounts for 2.37% to 25% of all renal disease and 27.2% to 80.65% of renal disease associated with secondary glomerular diseases. The male-to-female ratio is approximately 1:5 in lupus nephritis patients. The included period is predominantly from 1995 to 2010. The proportion ratio of biopsy-proven lupus nephritis in all renal disease or in secondary glomerular disease significantly increased with decreasing latitude from the north to the south part of China. The population is predominantly Han Chinese.
  
  
  CONCLUSIONS
  Geographical distribution appears to be a risk factor for the incidence of biopsy-proven LN in China.
authors.forename: Qingjun
authors.initials: Q
authors.lastname: Pan
authors.forename: Yaning
authors.initials: Y
authors.lastname: Li
authors.forename: Ling
authors.initials: L
authors.lastname: Ye
authors.forename: Zhenzhen
authors.initials: Z
authors.lastname: Deng
authors.forename: Lu
authors.initials: L
authors.lastname: Li
authors.forename: Yongmin
authors.initials: Y
authors.lastname: Feng
authors.forename: Weijing
authors.initials: W
authors.lastname: Liu
authors.affiliation: Institute of Nephrology, Affiliated Hospital of Guangdong Medical College, Zhanjiang, PR 524001, China. hf-liu@263.net.
authors.forename: Huafeng
authors.initials: H
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002648:Child; D002681:China / Q000453:epidemiology; D002980:Climate; D005260:Female; D006801:Humans; D015994:Incidence; D008181:Lupus Nephritis / Q000453:epidemiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012111:Residence Characteristics; D012307:Risk Factors; D017678:Sex Distribution; D012959:Socioeconomic Factors; D062211:Spatio-Temporal Analysis; D055815:Young Adult