肾小球肾炎(GN)是非洲肾衰竭的主要原因。在整个非洲,初级GNs的患病率差异很大,这取决于次级GNs的相对比例和遗传倾向。我们评估了非洲原发性GN及其组织学亚型的总体和分区域患病率。我们搜索了PubMed,EMBASE和非洲在线期刊,用于研究2010年至2022年期间非洲所有年龄段的活检证明的主要GNs。原发性GNs的数据[微小变化疾病(MCD),局灶性节段肾小球硬化(FSGS),膜性肾病(MN),血管增生性GN(MesPGN),膜增殖性GN(MPGN),感染后GN(PIGN),IgA肾病(IgAN),和新月体GN(CresGN)]被提取。使用随机效应模型确定合并患病率。来自8个非洲国家的17篇合格文章(n=6494人)符合纳入标准。FSGS的总体汇总患病率,MCD,MN,MPGN,MesPGN,PIGN,IgAN和CresGN分别为26.10%,22.40%,8.40%,6.40%,6.40%,2.60%,2.60%,1.40%,分别。只有4项研究(23.5%)使用光学显微镜(LM),免疫荧光(IF),和电子显微镜(EM)进行诊断。与成年人群相比,儿科的组织学亚型分布存在显着差异,西非的FSGS患病率较高。总的来说,FSGS在大多数地区和年龄组的优势对疾病诊断和持续治疗有影响.在非洲,需要研究努力了解这种趋势对肾脏疾病结局的影响,并努力改善肾脏活检实践作为早期疾病检测的一种手段。
Glomerulonephritis (GN) is a predominant cause of kidney failure in Africa. The prevalence of primary GNs varies widely across Africa depending on the relative proportion of secondary GNs and genetic predispositions. We assessed the overall and sub-regional prevalence of primary GN and its histologic subtypes in Africa. We searched PubMed, EMBASE and African Journals Online for studies of biopsy-proven primary GNs across all age groups in Africa published between 2010 and 2022. Data for primary GNs [minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), membranous nephropathy (MN), mesangioproliferative GN (MesPGN), membranoproliferative GN (MPGN), post-infectious GN (PIGN), IgA Nephropathy (IgAN), and crescentic GN (CresGN)] were extracted. Pooled prevalence was determined using the random effects model. Seventeen eligible articles (n = 6,494 individuals) from 8 African countries met the inclusion criteria. The overall pooled prevalence of FSGS, MCD, MN, MPGN, MesPGN, PIGN, IgAN and CresGN was 26.10%, 22.40%, 8.40%, 6.40%, 6.40%, 2.60%, 2.60%, 1.40%, respectively. Only 4 studies (23.5%) used light microscopy (LM), immunofluorescence (IF), and electron microscopy (EM) for diagnosis. There were significant differences in the distribution of histologic subtypes in the paediatric compared to the adult population and across geographic sub-regions, with West Africa having a higher prevalence of FSGS. Overall, the dominance of FSGS across most regions and age groups has implications for disease diagnosis and ongoing care. Research efforts to understand the impact of this trend on kidney disease outcomes and efforts to improve kidney biopsy practice as a means of early disease detection are needed in Africa.