Treatment of Glomerular Diseases in Lebanon

Abstract

Glomerulonephritis (GN) is rare kidney disease that often requires treatment with immunosuppressive drugs. The choice of therapy usually relies on international guidelines. There are no data so far regarding the treatment of glomerular diseases in the eastern Mediterranean region. This study aimed to describe the most frequently treated glomerular diseases among the Lebanese population. This is a retrospective study that reviewed all patients’ medication coverage claims, presented at the Lebanese Ministry of Public Health between 2014 and 2015. All patients that had kidney biopsies in their charts were included. A total of 144 patients were included: 35 children and 109 adults. Half of the children had minimal change disease treated with mycophenolate mofetil (MMF). In adults, 33% had lupus nephritis (LN) with a male to female ratio 12/24, 28.4% focal segmental glomerulosclerosis (FSGS), 14.6% membranous nephropathy (MN), and 24% other types. There was a significant difference in age among different GN (P = 0.01). MMF was the most commonly used drug in adults: 88.8% of LN cases, 51.6% in FSGS, 18.7% in MN, and 100% in immunoglobulin A nephropathy. This study showed that LN is the most frequently treated GN in Lebanon and was managed according to guidelines. MMF use was prevailing even in cases not suggested by the Kidney Disease Improving Global Outcomes. Further studies are needed to see whether these results apply to other countries.