title: Distribution of Biopsy-Proven Presumed Primary Glomerulonephropathies in 2000-2011 Among a Racially and Ethnically Diverse US Population.
abstract: BACKGROUND
  The incidence and distribution of primary glomerulonephropathies vary throughout the world and by race and ethnicity. We sought to evaluate the distribution of primary glomerulonephropathies among a large racially and ethnically diverse population of the United States.
  
  
  METHODS
  Case series from January 1, 2000, through December 31, 2011.
  
  
  METHODS
  Adults (aged ≥ 18 years) of an integrated health system who underwent native kidney biopsy and had kidney biopsy findings demonstrating focal segmental glomerulosclerosis (FSGS), membranous glomerulonephritis (MGN), minimal change disease (MCD), immunoglobulin A nephropathy (IgAN), and other.
  
  
  RESULTS
  Rates and characteristics of the most common primary glomerulonephropathies overall and by race and ethnicity.
  
  
  RESULTS
  2,501 patients with primary glomerulonephropathy were identified, with a mean age 50.6 years, 45.7% women, 36.1% Hispanics, 31.2% non-Hispanic whites, 17.4% blacks, and 12.4% Asians. FSGS was the most common glomerulonephropathy (38.9%) across all race and ethnic groups, followed by MGN (12.7%), MCD (11.0%), IgAN (10.2%), and other (27.3%). The FSGS category had the greatest proportion of blacks, and patients with FSGS had the highest rate of poverty. IgAN was the second most common glomerulonephropathy among Asians (28.6%), whereas it was 1.2% among blacks. Patients with MGN presented with the highest proteinuria (protein excretion, 8.3g) whereas patients with FSGS had the highest creatinine levels (2.6mg/dL). Overall glomerulonephropathy rates increased annually in our 12-year observation period, driven by FSGS (2.7 cases/100,000) and IgAN (0.7 cases/100,000). MGN and MCD rates remained flat.
  
  
  CONCLUSIONS
  Missing data for urine albumin and sediment, indication bias in performing kidney biopsies, and inexact classification of primary versus secondary disease.
  
  
  CONCLUSIONS
  Among a racially and ethnically diverse cohort from a single geographical area and similar environment, FSGS was the most common glomerulonephropathy, but there was variability of other glomerulonephropathies based on race and ethnicity.
authors.affiliation: Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA. Electronic address: john.j.sim@kp.org.
authors.forename: John J
authors.initials: JJ
authors.lastname: Sim
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Los Angeles, CA.
authors.forename: Michael
authors.initials: M
authors.lastname: Batech
authors.affiliation: Department of Renal Pathology, Kaiser Permanente Southern California, Los Angeles, CA.
authors.forename: Aviv
authors.initials: A
authors.lastname: Hever
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Los Angeles, CA.
authors.forename: Teresa N
authors.initials: TN
authors.lastname: Harrison
authors.affiliation: Division of Nephrology and Hypertension, Kaiser Permanente Los Angeles Medical Center, Los Angeles, CA.
authors.forename: Taurino
authors.initials: T
authors.lastname: Avelar
authors.affiliation: Regional Quality and Clinical Analysis, Southern California Permanente Medical Group, Kaiser Permanente Southern California, Pasadena, CA.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Kanter
authors.affiliation: Department of Research & Evaluation, Kaiser Permanente Southern California, Los Angeles, CA.
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Jacobsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005921:Glomerulonephritis / Q000453:epidemiology* / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D044469:Racial Groups; D012189:Retrospective Studies; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: IgA nephropathy (IgAN); Primary glomerulonephropathy; case series; epidemiology; focal segmental glomerulosclerosis (FSGS); glomerulonephritis; kidney biopsy; membranous glomerulonephritis (MGN); minimal change disease (MCD); nephrotic syndrome; race/ethnic predilection