Renal histopathology spectrum in the biopsy-proven native kidney diseases of adult Iranian population, southern Iran: 2019-2024.

BACKGROUND: Renal diseases strongly influence global health burden and healthcare costs, especially for countries with low and middle socio-demographic indices. This study aimed to provide data on kidney disorder patterns and compare results with our previous analysis of biopsy-proven renal diseases to determine how the pattern is changing in our region. METHODS: This cross-sectional analysis of 2,392 native renal biopsies was performed from 2019 to 2024 at the Namazi Hospital, a tertiary referral healthcare center in Shiraz, Iran. RESULTS: Of 2,392 native kidney biopsies, primary glomerulonephritis was the most common finding, with the leading diagnosis of membranous glomerulonephritis (MGN), followed by focal segmental glomerulosclerosis (FSGS), and mesangioproliferative GN (MesGN). For secondary GN, lupus nephritis (LN), diabetic nephropathy, and amyloidosis were prominent. Lupus nephritis was the only female-predominant subtype (p < 0.001). Significant male predominance was observed in MGN (p < 0.001), IgA nephropathy (p< 0.001), Amyloidosis (p< 0.05), and hypertensive nephropathy (p < 0.05), whereas most other renal biopsy subtypes showed no statistically significant gender differences (p > 0.05). Age-related analysis showed that LN was the predominant finding in patients <45 years, whereas MGN was the most common among older patients (P < 0.001). CONCLUSION: Comparing the proportions of biopsy results with our previous analysis revealed that FSGS and LN decreased dramatically, while MGN, Diabetic nephropathy, IgA nephropathy, and tubulointerstitial diseases showed increasing trends. These data provided essential clues for further studies on organizing renal health goals.