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Abstract: SA-PO394

Changes of Epidemiology, Renal and Patient Outcomes over Time in Glomerular Disease of Korea

Session Information

Category: Glomerular Diseases

  • 1203 Glomerular Diseases: Clinical, Outcomes, and Trials

Authors

  • Kang, Minjung, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Park, Sehoon, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
  • Oh, Kook-Hwan, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Chin, Ho Jun, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

Epidemiology of glomerular disease has been revealed temporal changes according to the population sanitation standard, socioeconomic status, and improvement of medical care. We aimed to explore changes of epidemiology, renal and patient outcome over time in glomerular disease (GD) in Korea, which is one of countries experienced rapid socioeconomic changes during short time.

Methods

After excluding 98 with more than the second times biopsy, 7,402 biopsy-proven primary and secondary GD patients from 1979 to 2018 are included from 2 tertiary hospitals. The outcome is CKD progression and all-cause mortality. CKD progression is defined as either incident ESRD or halving eGFR.

Results

During median 59 (18 - 138) months of follow-up period, patients who were taken kidney biopsy tended to be significantly older and more women over time. In overall, the most common primary GD was IgA nephropathy (IgAN), followed by membranous nephropathy (MN), minimal change disease (MCD), and focal segmental glomerulosclerosis (FSGS) with similar proportions. The most common secondary GD was lupus nephritis (LN), diabetic nephropathy (DN), and hepatitis-B-associated GN (HBGN). Proportion of IgAN had continuously increased over time, however it showed plateau since 2009, then it decreased to a certain degree. Proportion of MCD had decreased, whereas that of crescentic GD had increased as times go by. Diagnosis of MN or FSGS was not affected by the time change. Among secondary GDs, LN remained most common, however, it has decreased recently. DN has increased dramatically, whereas HBGN has decreased continuously. Patients presenting nephrotic syndrome has been decreased recently. 10-year renal survival was the lowest in DN (45.0%), followed by crescentic GD (62.0%), FSGS (78.4%), and IgAN (83.7%). Patient survival was the lowest in crescentic GD (76.6%), followed by DN (88.6%). Other GN showed similar patient survival with more than 90% of rate.

Conclusion

From our large cohort with long term follow-up, we identified significant changes in demographic or epidemiologic characteristics as well as outcomes of overall GDs. Improvement of socioeconomic and medical care may contribute to these changes.