Association of Socioeconomic Status with Glomerular Diseases at a Tertiary Care Hospital in Bangladesh

Abstract

Background: Social deprivation is a well-known risk factor for chronic kidney disease (CKD), however its association with glomerular diseases is less well understood. This study was aimed to evaluate the association of Socioeconomic Status (SES) with glomerular diseases among patients attending at a tertiary care hospital in Bangladesh. Methods: This cross sectional study was conducted at Department of Nephrology, Shaheed Sheikh Abu Naser Specialized Hospital, Khulna, Bangladesh from January 2016 to December 2020. A total of 184 diagnosed patients of glomerulonephritis (GN) were enrolled. Patient’s socioeconomic status (SES) was assessed using Modified BG Prasad socioeconomic classification. Morphological pattern of glomerular diseases were assessed according to the histopathology report. Relationship of glomerular diseases with particular socioeconomic status (SES) was identified. Results: Among 184 study patients 99 were male and 85 were female, their mean age was 31.18 ± 13.55 years. It was observed that, in proliferative variety; Mesengial Proliferative Glomerulonephtis (Mes PGN) was the leading morphological variant (34.7%) followed by Membranoproliferative Glomerulonephtis [MPGN (16.8%)], Lupus Nephritis [LN (7.1%)], Focal Segmental Proliferative Glomerulonephritis [FSPGN (7.1%)], IgA Nephropathy (6.5%), IgM Nephropathy (4.3%) and Crescentic Glomerulonephtis [Cres GN (2.2%) serially. In the non-proliferative glomerulonephtis; Membranous Nephropathy (MN) was the commonest form (10.9%) followed by Focal Segmental Glomerulosclerosis [FSGS (7.6%)] and Minimal Change Disease [MCD (2.7%)]. All types of GN were significantly prevalent in the lower socioeconomic classes (Class- III, IV, V), while the frequency of Mes PGN and MPGN were significantly higher in Class- IV and Class- V socioeconomic classes. Conclusion: Lower socioeconomic classes are associated with a higher incidence of glomerular diseases particularly Messangial Proliferative Glomerulonephritis (Mes PGN) and Membranoproliferative Glomerulonephritis (MPGN) in Bangladesh.