Membranoproliferative glomerulonephritis epidemiology and demographics

Overview

Membranoproliferative glomerulonephritis (MPGN) is observed in 6-12% of US patients receiving renal biopsies. This entity accounts for 7% of children and 12% of adults with idiopathic nephrotic syndrome. MPGN causes significant proportion of the cases of nephritis among patients in nonindustrialized countries. For example, in Mexico, MPGN accounts for 40% of all patients with nephritis. Most of these patients have type I disease; MPGN type II is uncommon. However, the incidence of MPGN type I is decreasing progressively in developed countries, which may be explained by a change in environmental factors, especially a decline in infections. In an investigation of the changing patterns of adult primary glomerular disease occurrence in a single region of the United Kingdom, Hanko analyzed the results of 1844 native renal biopsies taken between 1976 and 2005 (inclusive) and found the presence of primary glomerulonephritis was revealed in 49% of the biopsies, with the most common forms being immunoglobulin A (IgA) nephropathy (38.8%). Other common forms were membranous nephropathy (29.4%), minimal-change disease (MCD) (9.8%), MPGN type 1 (9.6%), and focal segmental glomerulosclerosis (FSGS) (5.7%). The incidence of IgA nephropathy increased significantly over the study period, whereas the occurrence of membranous nephropathy decreased. In the United States, MPGN predominantly affects the white population. Type I disease affects women more often than men, whereas a nearly equal sex distribution is seen in MPGN type II. The idiopathic forms of MPGN are more common in children and young adults (range, 6-30 y). Isolated reports of involvement in patients as young as 2 years and as old as 80 years are noted in the literature. Secondary types of MPGN predominate among adults. By dividing glomerular diseases into two subtypes, which are Nephrotic or Nephritic, subdividing into several specific disease will be much more easier^[1]^[2] .The incidence of MPGN (as a lesion in renal biopsies) ranges from 1.4 to 9.3 cases per million population ^[1](pmp) per year and with few exceptions, the incidence has decreased over time.

Epidemiology and Demographics

Incidence

The incidence of MPGN is approximately 1.4 to 9.3 cases per million population per year worldwide.^[1]

Prevalence

prevalence of MPGN is approximately 4.6-6.6 per 100,000 individuals worldwide.

Age

Patients of all age groups may develop MPGN.
The incidence of MPGN increases with age,the median age at diagnosis is 31 years.
MPGN commonly affects individuals from 2 to 80 year of age.

Race

MPGN usually affects individuals of the white and black race.
Asian individuals are less likely to develop MPGN.

Gender

MPGN affects men and women almost equally.
Males are more commonly affected by MPGN than females.
The men with specified MPGN are 50.8% of total glomerular diseases
In females the incidence is 48.9% of total glomerular diseases.
Type I MPGN disease affects women more often than men

Region

The majority of MPGN cases are reported in united kingdom.

The next common region is united states.^[1]^[2]^[3]

Age-adjusted trends in patient demographics among patients with specified glomerular disease diagnoses*
demographic variables		1986-1995, %	1996-2005, %	2006-2015, %	Total, %
Gender	Male	51.9	50.1	51.1	50.8
	Female	48	49.1	48.8	48.9
	missing sex	0.1	0.8	0.1	0.3
Race	White	64.1	56.5	54.7	56.8
	Black	34.5	39.9	38.2	38.3
	Latino	0.6	1.8	4.2	2.8
	Asian	0.0	1.0	2.0	1.4
	Other	0.8	0.6	0.9	0.8
*These are datas for USA population

By dividing glomerular diseases into two subtypes, which are Nephrotic or Nephritic, subdividing into several specific disease will be much more easier^[1]^[2] .The incidence of MPGN (as a lesion in renal biopsies) ranges from 1.4 to 9.3 cases per million population (pmp) per year and with few exceptions, the incidence has decreased over time^[4]

Temporal trends in the renal biopsy frequencies of glomerular disease subtypes among patients with specified glomerular disease diagnoses*
demographic variables		1986-1995, %	1996-2005, %	2006-2015, %	Total, %
Nephrotic subtypes	FSGS	22.6	27.2	24.7	25.3
	Diabetic glomerulosclerosis	5.5	11.4	19.1	14.2
	Membranous nephropathy	17.8	13.8	10.6	12.9
	Minimal change disease	8.8	5.5	4.1	5.3
	MPGN	4.5	2.9	2.5	3.0
	Amyloidosis	2.2	2.0	2.5	2.3
	MIDD	0.6	0.6	1.6	1.1
	Dense deposit disease	2.2	2.0	2.5	2.3
	Fabry disease	0.1	0.1	0.0	0.1
	Collagenofibrotic glomerulopathy	0.1	0.0	0.0	0.0
	Total	52.4	63.7	65.3	64.3
Nephritic subtypes	Lupus nephritis	12.8	13.9	11.2	12.5
	IgAN	10.2	11.4	9.4	10.3
	ANCA/pauci-immune GN	9.3	6.8	8.3	7.9
	TBM lesion	1.9	1.3	3.0	2.2
	Fibrillary GN	1.5	1.2	1.4	1.4
	Anti-GBM nephritis	1.1	1.0	0.8	0.9
	Alport syndrome	0.6	0.4	0.5	0.5
	Immunotactoid GN	0.2	0.1	0.1	0.1
	Total	37.6	36.3	34.7	35.7
*These are datas for USA population

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 ^1.4 Sangeetha Murugapandian, MD, Iyad Mansour, MD, Mohammad Hudeeb, MD, Khaled Hamed, MD, Emad Hammode, MD, Babitha Bijin, MD, Sepehr Daheshpour, MD, Bijin Thajudeen, MD, and Pradeep Kadambi, MD (2016). “Epidemiology of Glomerular Disease in Southern Arizona”. Medicine. 95.
↑ ^2.0 ^2.1 ^2.2 Michelle M. O’Shaughnessy, Susan L. Hogan, Caroline J. Poulton, Ronald J. Falk, Harsharan K. Singh, Volker Nickeleit, and J. Charles Jennette (2017). “Temporal and Demographic Trends in Glomerular Disease Epidemiology in the Southeastern United States, 1986–2015”. Clinical Journal of the American Society of Nephrology. 12.
↑ Bassam Alchi & David Jayne (2010). “Membranoproliferative glomerulonephritis”. Pediatr Nephrol, Springer.
↑ Patrick Maisonneuve, MD, Lawrence Agodoa, MD, Ryszard Gellert, MD, John H. Stewart, MB, Gherardo Buccianti, MD, Albert B. Lowenfels, MD, Robert A. Wolfe, PhD, Elisabeth Jones, MD, Alex P.S. Disney, MD, Douglas Briggs, MD, Margaret McCredie, PhD, and Peter Boyle, PhD. “Distribution of Primary Renal Diseases Leading to End-Stage Renal Failure in the United States, Europe, and Australia/New Zealand: Results From an International Comparative Study”. American Journal of Kidney Diseases. 35.

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[:0-1] 1.0 ^1.1 ^1.2 ^1.3 ^1.4 Sangeetha Murugapandian, MD, Iyad Mansour, MD, Mohammad Hudeeb, MD, Khaled Hamed, MD, Emad Hammode, MD, Babitha Bijin, MD, Sepehr Daheshpour, MD, Bijin Thajudeen, MD, and Pradeep Kadambi, MD (2016). “Epidemiology of Glomerular Disease in Southern Arizona”. Medicine. 95.

[:1-2] 2.0 ^2.1 ^2.2 Michelle M. O’Shaughnessy, Susan L. Hogan, Caroline J. Poulton, Ronald J. Falk, Harsharan K. Singh, Volker Nickeleit, and J. Charles Jennette (2017). “Temporal and Demographic Trends in Glomerular Disease Epidemiology in the Southeastern United States, 1986–2015”. Clinical Journal of the American Society of Nephrology. 12.

[:2-3] Bassam Alchi & David Jayne (2010). “Membranoproliferative glomerulonephritis”. Pediatr Nephrol, Springer.

[4] Patrick Maisonneuve, MD, Lawrence Agodoa, MD, Ryszard Gellert, MD, John H. Stewart, MB, Gherardo Buccianti, MD, Albert B. Lowenfels, MD, Robert A. Wolfe, PhD, Elisabeth Jones, MD, Alex P.S. Disney, MD, Douglas Briggs, MD, Margaret McCredie, PhD, and Peter Boyle, PhD. “Distribution of Primary Renal Diseases Leading to End-Stage Renal Failure in the United States, Europe, and Australia/New Zealand: Results From an International Comparative Study”. American Journal of Kidney Diseases. 35.

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