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  1. Zainal D, Riduan A, Ismail AM, Norhayati O
    PMID: 8525403
    Renal biopsy is essential in the management of renal parenchymal diseases. Thus far there is no publish report on the pattern of glomerulonephritis in Kelantan. We decided to establish the pattern of glomerulonephritis in Kelantan and use this information as our reference in future studies. Records of patients who had proven glomerulonephritis histologically were analysed. Their biological data, clinical presentation, etiology and clinicopathological pattern were studied. Where appropriate mean and standard deviation were calculated. A total of 74 biopsies were performed during the study period (between January 1991 and December 1993), out of which 72 biopsies (97.3%) were considered suitable for analysis. The male to female ratio was 1:1.1. Mean age at presentation was 27.6 +/- 12.2 years. Nephrotic syndrome was the commonest clinical presentation (65.3%). The main underlying cause was systemic lupus erythematosus (50%) followed by primary glomerulonephritis. Histologically, IgA nephropathy and minimal change disease were the main patterns among patients with primary glomerulonephritis while diffuse proliferative glomerulonephritis was the commonest pattern among patients with lupus nephritis. Hence the pattern of glomerulonephritis is similar to other reported series. The procedure is considered safe and has a high success rate.
    Matched MeSH terms: Glomerulonephritis, IGA/pathology
  2. Peh SC, Looi LM, Wang F, Chua CT, Tan HW, Lam KL
    Malays J Pathol, 1990 Jun;12(1):21-6.
    PMID: 2090886
    In the 10-year period from October 1977 to July 1987, 149 cases of primary IgA nephropathy were histologically confirmed through renal biopsies in the Department of Pathology, University Hospital, Kuala Lumpur. The ages of these patients ranged from 5 to 72 years, with the majority in the 20-30 year age group. There was no sex preponderance. The ethnic distribution showed a significant predominance of Chinese with 107 (71.8%) Chinese, 24 (16.1%) Malays, 15 (10.1%) Indians and 3 others. A wide range of renal glomerular pathology was seen, the commonest being diffuse mesangioproliferative glomerulonephritis (59.1%). Focal proliferative glomerulonephritis (14.1%) followed by minimal change glomerulonephritis (10.7%) were next in order of frequency. Immunofluorescence studies consistently demonstrated heavy and predominant IgA deposition in the mesangium. Weak deposition of C3, IgG and IgM were also observed in various combinations.
    Matched MeSH terms: Glomerulonephritis, IGA/pathology*
  3. Cheong IK, Phang KS, Suleiman AB, Morad Z, Kong BC
    Med J Malaysia, 1986 Jun;41(2):139-43.
    PMID: 3821609
    A total of 45 patients with IgA nephropathy were seen at the Department of Nephrology, General Hospital, Kuala Lumpur and the Department of Medicine, Universiti Kebangsaan Malaysia (National University ofMalaysia) between January 1982 to June 1985. This represents an incidence of 10.7% of all primary glomerulopathies. There does not appear to be any racial predilection and the clinicopathological features generally conforms with those reported elsewhere. However it seems to be as common in females as in males but the latter have a worse prognosis. The high incidence of renal failure and hypertension in our patients within the short follow-up period is noteworthy.
    Matched MeSH terms: Glomerulonephritis, IGA/pathology*
  4. Mohd R, Mohammad Kazmin NE, Abdul Cader R, Abd Shukor N, Wong YP, Shah SA, et al.
    PLoS One, 2021;16(4):e0249592.
    PMID: 33831052 DOI: 10.1371/journal.pone.0249592
    INTRODUCTION: IgA nephropathy (IgAN) has a heterogeneous presentation and the progression to end stage renal disease (ESRD) is often influenced by demographics, ethnicity, as well as choice of treatment regimen. In this study, we investigated the long term survival of IgAN patients in our center and the factors affecting it.

    METHODS: This study included all biopsy-proven IgAN patients with ≥ 1year follow-up. Patients with diabetes mellitus at diagnosis and secondary IgAN were excluded. Medical records were reviewed for demographics, clinical presentation, blood pressure, 24-hour urine protein, serum creatinine, renal biopsy and treatment received. The primary outcome was defined as combined event of 50% estimated glomerular filtration rate (eGFR) reduction or ESRD.

    RESULTS: We included 130 (74 females; 56 males) patients of mean age 38.0 ± 14.0 years and median eGFR of 75.2 (interquartile range (IQR) 49.3-101.4) ml/min/1.73m2. Eighty-four (64.6%) were hypertensive at presentation, 35 (26.9%) had nephrotic syndrome and 57 (43.8%) had nephrotic range proteinuria (NRP). Median follow-up duration was 7.5 (IQR 4.0-13.0) years. It was noted that 18 (13.8%) developed ESRD and 34 (26.2%) reached the primary outcome. Annual eGFR decline was -2.1 (IQR -5.3 to -0.1) ml/min/1.73m2/year, with median survival of 20 years. Survival rates from the combined event (50% decrease in eGFR or ESRD) at 10, 20 and 30 years were 80%, 53% and 25%, while survival from ESRD were 87%, 73% and 65%, respectively. In the univariate analysis, time-average proteinuria (hazard ratio (HR) = 2.41, 95% CI 1.77-3.30), eGFR <45ml/min/1.73m2 at biopsy (HR = 2.35, 95% CI 1.03-5.32), hypertension (HR = 2.81, 95% CI 1.16-6.80), mean arterial pressure (HR = 1.02, 95% CI 1.01-1.04), tubular atrophy/interstitial fibrosis score (HR = 3.77, 95% CI 1.84-7.73), and cellular/fibrocellular crescent score (HR = 2.44, 95% CI 1.19-5.00) were found to be significant. Whereas only time-average proteinuria (TA-proteinuria) remained as a significant predictor in the multivariate analysis (HR = 2.23, 95% CI 1.57-3.16).

    CONCLUSION: In our cohort, TA-proteinuria was the most important predictor in the progression of IgAN, irrespective of degree of proteinuria at presentation.

    Matched MeSH terms: Glomerulonephritis, IGA/pathology*
  5. Looi LM
    Malays J Pathol, 1994 Jun;16(1):19-21.
    PMID: 16329571
    An analysis of 1000 consecutive, adequate renal biopsies from patients of the University Hospital Kuala Lumpur between 1982 and 1991 revealed: minimal change nephritis (20.7%), focal glomerulosclerosis (2.9%), proliferative glomerulonephritides (16.0%), membranous glomerulonephritis (5.5%), IgA nephropathy (18.5%), lupus nephritis (24.9%), end stage nephropathy (3.1%) and others (8.4%). Compared with the previous decade, IgA nephropathy has emerged as a common entity. Lupus nephritis forms the largest diagnostic entity and is probably related to the selected referral of SLE patients to this hospital.
    Matched MeSH terms: Glomerulonephritis, IGA/pathology
  6. Draman CR, Kong NC, Gafor AH, Rahman AF, Zainuddin S, Mustaffa WM, et al.
    Singapore Med J, 2008 Nov;49(11):924-9.
    PMID: 19037561
    Angiotensin-converting enzyme (ACE) gene polymorphism, especially the deletion/deletion (DD) genotype, is associated with the disease progression of immunoglobulin A (IgA) nephropathy patients in various studies from both Asia Pacific and European populations. However, recent studies within the same populations were unable to reproduce the same results. Hence, we had studied the distribution of the DD genotype, the association between ACE gene polymorphism and the disease progression, and the factors (other than ACE gene polymorphism) which were involved in the disease progression of our local patients.
    Matched MeSH terms: Glomerulonephritis, IGA/pathology*
  7. Woo KT, Chan CM, Mooi CY, -L-Choong H, Tan HK, Foo M, et al.
    Clin. Nephrol., 2010 Nov;74(5):372-83.
    PMID: 20979946
    This review of 2,586 renal biopsies over the past 3 decades in Singapore documents the changing pattern of glomerulonephritis (GN) from that of a third world country to that of a developed nation. In the 1st decade, mesangial proliferative glomerulonephritis was the most common form of primary GN, just as it was in the surrounding Asian countries. In the 2nd decade, the prevalence of mesangial proliferative GN decreased with a rise in membranous, GN which is also seen in China and Thailand. In the 3rd decade, there was a dramatic increase in focal sclerosing glomerulosclerosis. This increase reflects aging and obesity in keeping with more developed countries like Australia, India, Thailand and the United States of America. IgA nephritis remains the most common GN. Apart from the geographical influence, other socioeconomic factors play a significant role in the evolution of the renal biopsy pattern. Mesangial proliferative GN remains prevalent in many Asian countries, but in Singapore the prevalence is decreasing just as it is in Japan, Korea and Malaysia. Worldwide, the prevalence of focal sclerosing glomerulosclerosis continues to increase in many countries.
    Matched MeSH terms: Glomerulonephritis, IGA/pathology
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