Changes in primary glomerulonephritis in Singapore over four decades
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This review of 3,289 native kidney biopsies over the past four decades in Singapore documents the changing pattern of biopsy-proven glomerulonephritis (GN) from that of a third world country to that of a developed nation. In the lst decade, mesangial proliferative GN was the most common form of primary GN, similar to the Asian region. In the 2nd decade. the percentage of mesangial proliferative GN decreased, but membranous GN became more common, as was seen in China and Thailand. In the 3rd decade, focal segmental glomerulosclerosis (FSGS) and membranous nephropathy continued to rise. but it was only recently, in the 4th decade, that FSGS prevalence increased dramatically. although membranous nephropathy continues to increase in some Asian countries. In the last decade in Singapore, Malaysia. and Japan, prevalence of IgA nephritis has decreased but remains the most common GN. The percentage of FSGS continues to increase in many countries like in Italy, United States of America, United Kingdom. China, and Malaysia. We surmise that socioeconomic factors play significant roles in the evolution of the renal biopsy pattern.