Purpose This systematic review aims to synthesize data from biopsy‐based studies to quantify the epidemiology, regional variations, and temporal trends of glomerular diseases (GDs) in Saudi Arabia. Methods We conducted a systematic search using PubMed, MEDLINE, the Cochrane Library, and Google Scholar to identify relevant studies published up to January 1, 2025. Studies reporting native renal‐biopsy data from Saudi Arabia, with histopathological confirmation of GD, were included. Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, and study quality was assessed using the Newcastle–Ottawa Scale. Results Twelve studies (4066 patients) were included, representing all major regions of Saudi Arabia between 1989 and 2017. Primary GD accounted for 50%–80% of all biopsies, while secondary GD represented 18%–48%. Focal segmental glomerulosclerosis (FSGS) was the most common primary GD (15%–40% of cases), while lupus nephritis dominated secondary GD (55%–75%). Nephrotic syndrome was the principal indication for biopsy in all adult cohorts (40%–65%), particularly with minimal change disease (MCD), FSGS, and membranous glomerulonephritis (MGN) subtypes. Temporal trends revealed an increase in IgA nephropathy and diabetic nephropathy, with a decline in membranoproliferative glomerulonephritis. Notable regional variations were also identified. Progression to ESRD was observed in 25%–35% of crescentic and FSGS cases. Conclusion This review highlights the evolving landscape of GDs in Saudi Arabia, emphasizing the need for early diagnosis, standardized biopsy protocols, and multidisciplinary management. A national renal biopsy registry is recommended to improve surveillance and research collaboration.
Alotaibi et al. (Thu,) studied this question.