Distinct patterns of glomerular disease in Lima, Peru

Aim;We performed both a retrospective and prospective study to elucidate th e types of glomerular diseases present in adults in Lima, Peru. Material an d methods: In the retrospective study, we analyzed 1263 renal biopsies over a 10-year period (1985 - 1995) that were processed at a central reference renal pathology laboratory in Lima. 101 cases were examined in the prospect ive study. Results: The most common glomerular diseases observed were those due to systemic lupus erythematosus (30.2%), membranoproliferative glomeru lonephritis (MPGN, 14.8%), and focal and segmental glomerulosclerosis (FSGS , 13.9%). Although mesangial-proliferative nephritis was observed in 9.5% o f cases, IgA nephropathy was rare (0.9%). Examination of the year to year f requency showed that MPGN has tended to decrease in frequency with time whe reas FSGS has been increasing. Although there is known to be a high frequen cy of infections in Peru, only 4.2% of the cases in the retrospective study were associated with infection. Furthermore, in the prospective study, onl y one case of hepatitis C and no cases of hepatitis B viral infection were detected, including in the ii cases of MPGN observed. Conclusion;We conclud e that the epidemiology of glomerular disease in Lima, Peru, is distinct fr om most areas of the world, but has similarities to certain regions in Afri ca, in that MPGN is common whereas IgA nephropathy appears to be rare. Furt her studies are necessary to elucidate the reasons why the patterns of glom erular disease are different from that observed in other parts of the world .