Clinicopathologic spectrum of glomerular diseases in a tertiary care hospital

Abstract

Introduction: Biopsy-proven renal diseases give an insight into the prevalence of glomerular diseases. These are uncommon diseases which differ according to geographical area, demography, age, and race of a population. Aims: This study was aimed to evaluate the histopathological spectrum of glomerular diseases in native kidney biopsies. The secondary aim of the study was to review the literature for pattern of occurrence of glomerular diseases in and around the Indian subcontinent. Settings and Design: The present study was a retrospective observational study conducted at a tertiary care hospital for a period of 2 years. Subjects and Methods: One hundred and six consecutive native kidney biopsies performed under ultrasonographic guidance were done, and two renal core tissues, which were obtained in each case, were evaluated for light microscopy and immunofluorescence. Results: The age at presentation varied from 6 to 70 years, and maximum cases belonged to the third and fourth decades. The male-to-female ratio was 1.6:1. The most common clinical indication for performing the renal biopsy was nephrotic syndrome in 68 cases (64%). The primary glomerular diseases accounted for 86 cases (81.1%), and the remaining were secondary. Minimal change disease (MCD) was the most common histological lesion (29.2%), followed by focal segmental glomerulosclerosis. Among the secondary glomerular diseases, lupus nephritis was the most common, followed by amyloidosis. Conclusion: In this study of biopsy-proven renal disease, primary glomerulonephritis was found to be more common than secondary causes. Of the primary glomerulonephritis, MCD was the most common renal disease in patients of nephrotic syndrome. The study also highlights the similarities and differences in the spectrum of renal diseases in different regions of the Indian subcontinent.

Keywords

• glomerular diseases
• minimal change disease
• renal biopsy
• spectrum