Clinicopathologic spectrum of glomerular diseases in a tertiary care hospital

Bhalla, Shalini; Ahmad, Muffazal; Raghuvanshi, Shivanjali; Agarwal, Preeti

doi:10.4103/kleuhsj.kleuhsj_118_20

Cited by 3 publications

(5 citation statements)

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“…This could stem from the fact that younger subjects in the age group of 30–40 years are usually the earning members of the family and are more likely to seek hospitalization for their ailments. The reported mean age is in line with other studies from India [ 4 , 5 ]. Our study has shown a much higher percentage of RPRF cases in both the groups (39.3% in group 1 and 28% in group 2 respectively) as compared to that reported from other centres ranging from 10 to 20% [ 6 , 7 ].…”

Section: Discussionsupporting

confidence: 91%

“…This explains the reason behind the higher number of nephrotic patients biopsied in group 2. IgA nephropathy was identified as the most common form of primary glomerulonephritis which is different from what has been reported by Bhalla et al and Muthu et al who reported minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) respectively as the most common primary glomerulonephritis in their studies [ 5 , 7 ]. The treatment offered to the nontransplant patients in both the groups included use of prednisolone, mycophenolate mofetil and cyclophosphamide with no significant difference between the groups.…”

Section: Discussionmentioning

confidence: 79%

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Impact of COVID 19 pandemic on patients requiring renal biopsy

et al. 2022

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Introduction The disruption of healthcare services in coronavirus disease (COVID)19 pandemic was widespread particularly due to lockdown curbs. This study was undertaken to see the effect of this pandemic on subjects requiring renal biopsy. Materials and method Renal biopsies performed during the COVID 19 pandemic between April 2020 and December 2020 (Group 1) were compared with those in pre-COVID period between June 2019 and February 2020 (Group 2). Indication of biopsies, syndromic diagnosis and all baseline laboratory characteristics were retrieved from the hospital records. Results 130 and 191 patients were biopsied in groups 1 and 2, respectively. Patients in group 1 were younger compared with group 2 (32.55 ± 15.60 and 36.37 ± 16.96 years, respectively, p value 0.038). The mean serum creatinine value in group 1 was significantly higher than in group 2 (3.21 ± 2.08 and 2.68 ± 2.02 mg/dl respectively, p value: 0.023). Group 1 comprises a significantly higher percentage of rapidly progressive renal failure patients (RPRF) (39.3 vs 28, p value 0.046). A higher percentage of nephrotics was biopsied in group 2 vs group 1 (46.9 vs 30.4 respectively, p value 0.008). The treatment protocol remained similar in both the groups. Evaluation of the transplant biopsies revealed a nonsignificant higher number of rejections in group 1 (11 out of 18) as compared to group 2 (5 out of 16), p value 0.100. Combined rejection saw a lesser use of rATG in group 1. Conclusion COVID pandemic induced restrictive measures could have led to selective high risk patients with RPRF as presumptive diagnosis and higher creatinine values getting biopsied. Higher rejections were noticed in transplant recipients pointing towards the need of establishing a more efficient support system for managing such patients.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 79%

Impact of COVID 19 pandemic on patients requiring renal biopsy

et al. 2022

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“…Massive proteinuria (>10 gm/day) was seen in 16.66% patients who had underlying MCD (6.67%), Immune Complex GN (6.67%) or MGN (3.33%). In a study by Ho Sik Shin et al in South Korea (2017) it was observed that adults in age group of 18 -59 years who underwent kidney biopsy most commonly presented with asymptomatic urinary abnormalities (75.3%), followed by nephrotic syndrome (19.8%) and acute kidney injury (3.4%) [16]. Almost all of the patients had hypoalbuminemia with a mean serum level of 2.51 ± 0.76 gm/dl.…”

Section: Discussionmentioning

confidence: 99%

“…However, MCD comprised only 10.2% of the total biopsies in a study in Nepal [5], MCD shows a variable geographic distribution and is more common in Asia than in North America or Europe [6] In Korea [7] and Thailand [8], MCD amounted to 26.6% and 45.8% of all primary glomerular diseases, respectively, FSGS was observed to be the most common Primary Glomerulo-nephropathy in Brazil [9], India [10], Bahrain [11], Croatia [12] and Sudan [13], 34.5% in Czech Republic [14], whereas 18.8% in Italy [15]. However, MCD was the most common biopsy proven Primary glomerular disease with wide age of presentation in a study by Shalini Bhalla et al in Uttar Pradesh in India [16]. Proteinuria (60%), microscopic haematuria (13.33%), pedal oedema (13.33%) and anasarca (13.33%) were among the most common presentations seen in majority of study subjects.…”

Section: Discussionmentioning

confidence: 99%

Spectrum of Primary Glomerular Diseases in Patients Presenting with Urinary Abnormalities

Vohra¹,

Shrutiraaj²,

Dalal³

et al. 2022

OJNeph

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Introduction: Primary Glomerular Diseases are a spectrum of renal disorders of unknown aetiology with distinct characteristics, specific natural history and prognosis. A thorough evaluation is pre-requisite to establish the diagnosis since many systemic diseases and secondary aetiology masquerade as primary diseases. Methods: This prospective observational study was conducted at a tertiary care centre and included 30 patients, with clinical features suggestive of primary glomerular diseases, of which 23 patients (76.6%) were males and 07 patients (23.33%) were females. The mean age at presentation was 37.23 ± 12.89 years. Among the observed spectrum of Primary Glomerular Diseases, IgA Nephropathy (IgA N) was seen in 26.67% patients, Focal Segmental Glomerulosclerosis (FSGS) in 20% patients and Membranous Glomerulopathy (MGN) in 13.33% patients, whereas the incidence of other abnormalities had less percentage contribution. Proteinuria was the commonest presentation seen in 60% patients, followed by Microscopic Haematuria in 20%. Mean Serum Creatinine was 0.99 ± 0.16 mg/dl. Mean Serum Albumin was 2.51 ± 0.76 gm/dl. Overall Nephrotic range proteinuria was observed in 15 (50%) patients. Results: IgA N, FSGS & MGN were the commonest observed Primary Glomerular Diseases. Proteinuria, Haematuria, Anasarca and Pedal Oedema were the commonest observed clinical presentations. Conclusions: In this studied series IgA Nephropathy, FSGS and MGN were the most prevelant diagnoses in the patients presenting with Urinary Abnormality. Nephrotic range Protenuria was the major indication for biopsy, there is a temporal variation in glomerulopathies wherein there is increase in incidence of IgA Nephropathy and decrease in incidence of FSGS.

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“…Kidney biopsy is an essential tool in nephrologists' clinical practice for determining diagnosis, prognosis, and therapy of a variety of glomerular illnesses [1]. A kidney biopsy is a reasonably safe procedure, with less than 0.1% of biopsies resulting in lifethreatening consequences [2]. A diverse pattern and frequency of glomerular disorders has been reported in various studies [3,4].…”

Section: Introductionmentioning

confidence: 99%

A Cross-Sectional Study on Histological Pattern of Primary Glomerular Diseases among Adult Patients

Khan¹,

Elahi²,

Hamza³

et al. 2023

PJMHS

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Background and Aims: Primary glomerulonephritis (GN) is the major cause for end-stage renal disease (ESRD) and considered to contribute in 52% cases. Kidney biopsy is an essential tool in nephrologists' clinical practice for determining diagnosis, prognosis, and therapy of a variety of glomerular conditions. The purpose of the present study was to determine the primary glomerular diseases histopathological pattern among adult patients. Patients and Methods: A total of 94 suspected primary glomerular disease (GD) patients were investigated in this cross-sectional study conducted in the Nephrology Unit of Medicine department of Mayo Hospital, Lahore from 21st January 2021 to 20th February 2022. Individual’s demographic details, diagnostic tests, clinical presentation, kidney biopsy indications, and post-biopsy complications were recorded on pre-designed questionnaire/pro-forma. Data analysis was done using SPSS version 27. Results: Out of 94 patients, about 76 (80.9%) patients had primary glomerular disease diagnosed on native kidney biopsies. The overall mean age was 38.4± 6.2 years. Out of 94 primary glomerular disease patients, there were 48 (51.1%) male and 46 (48.9%) females. The incidence of nephrotic syndrome and unexplained renal parameters elevations were 47.4% (n=36) and 31.6% (n=24) respectively. The prevalence of Primary focal segmental glomerulosclerosis (FSGS), membrano-proliferative glomerulonephritis (MPGN), minimal change disease, and IgA nephropathy was 30.3% (n=23), 25% (n=19), 17.1% (n=13), and 6.6% (n=5) respectively. Kidney biopsy post-complications were found in 8 (10.5%) cases. Conclusion: The present study observed that MPGN and FSDS were the most prime causes for primary glomerular disease. The most prevalent indication of kidney biopsy was nephrotic syndrome. Keywords: Glomerular disease, kidney biopsy, histopathological pattern, adult patients

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Clinicopathologic spectrum of glomerular diseases in a tertiary care hospital

Cited by 3 publications

References 0 publications

Impact of COVID 19 pandemic on patients requiring renal biopsy

Impact of COVID 19 pandemic on patients requiring renal biopsy

Spectrum of Primary Glomerular Diseases in Patients Presenting with Urinary Abnormalities

A Cross-Sectional Study on Histological Pattern of Primary Glomerular Diseases among Adult Patients

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