<p><strong>Objective:</strong><strong> </strong>To report our experience with renal biopsy and histopathological pattern of renal disease in a tertiary care hospital in Pakistan over 11 years period.</p><p><strong>Methods:</strong><strong> </strong>All the kidney biopsies performed in our unit from Jan 2001 to Dec 2011 were retrospectively reviewed. We recorded the following data for each patient: name, age, sex, indications for renal biopsy, histopathological diagnosis and lab investigations such as Serum Creatinine, 24 hour urinary protein, urine microscopy, virology (Hbs Ag, Anti HCV) and serology (antids DNA, ANA, C3, C4, C-ANCA and p-ANCA) when indicated. Histopathological examination included Light Microscopy (LM) and Immunofluorescence Microscopy (IF). For LM, six sections were taken and stained with Haemotoxilin and Eosin, and special stains included Periodic acid-Schiff (PAS), Trichome and Grocott’ Smethanamine Silver Stain (GMS). IF study was done using polyclonal antisera against human IgG, IgM, IgA, C3 and Cq. The renal biopsies were performed by a trained Nephrologist.</p><p><strong>Results:</strong><strong> </strong>A total of 329 consecutive percutaneous renal biopsies of native kidneys were reviewed. A total of thirteen specimens were unsatisfactory. Nineteen cases had incomplete data, therefore were excluded. There were 159 males (53.3%) and 138 females (46.46%). Age distribution showed a total no. of 34 (11.44%) of paediatric cases, 238 (80.13%) adult cases and 25 (10.5 %) elderly cases. The most common clinical indication for renal biopsy was unexplained renal failure (n = 116 39%) followed by nephrotic syndrome (n = 83 27.9%). Of the total biopsies included 248 (82.82%) had glomerular disease and 49 (16.49%) had non glomerular disease. The most frequently found primary glomerular lesion was membranous nephropathy (n = 51 17%) followed by focal segmental glomerulosclerosis (n = 26 8.7%). Amongst the non-glomerular lesions, CIN (chronic interstitial nephritis) was the most frequently found lesion (n = 24 8.08%).</p><p><strong>Conclusion: </strong>Membranous Nephropathy followed by Focal Segmental Glomerulosclerosis were the most frequently found renal lesion.</p>
OBJECTIVE: To determine cut off value of procalciton (PCT) in aseptic end stage renal disease patients undergoing haemodialysis. BACKGROUND: Haemodialysisis considered as a proinflammatory state and therefore associated with release of inflammatory cytokines and acute phase reactant proteins. The conventional laboratory markers (C-reactive protein, erythrocyte sedimentation rate) are efficient tools for the diagnosis of infection in patients with normal kidney functions. However they can be nonspecifically elevated in patients on haemodialysis and only reflect inflammatory response not associated with infection. PCT is considered a very important biomarker in differentiating infections from inflammation. The study was undertaken to evaluate normal serum levels of PCT in patients undergoing HD.PATIENTS AND METHOD: The study included 82 end-stage renal failure patients without evidence of systemic or localized infection undergoing maintenance haemodialysis. RESULTS: In our study, the PCT concentrations showed a mean of .622ng/ml in patients on maintenance hemodialysis without signs of infection. CONCLUSION:The study suggests that serum PCT at a cutoff value of .62ng/ml should be considered normal in aseptic haemodialysis patients. KEYWORDS: Procalcitonin, haemodialysis, sepsis
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