Insight to changing morphologic patterns of glomerulopathy in adult Pakistani patients: an institutional perspective

Hashmi, Atif Ali; Hussain, ZubaidaFida; Edhi, Muhammad Muzzammil; Mumtaz, Shazia; Faridi, Naveen; Khan, Mehmood

doi:10.1186/s13104-016-1876-y

Cited by 8 publications

(6 citation statements)

References 19 publications

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“…In the present study, primary focal segmental glomerulosclerosis (53.8%) was the most common histological diagnosis. Our findings are also in agreement with multiple local studies 15,16 and international studies 17,18 . As far as we reviewed the literature on FSGS, we noted it as the most prevalent type of histological pattern among Asians of middle age.…”

Section: Discussionsupporting

confidence: 93%

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Morphological Audit of glomerular diseases in a tertiary care Hospital.

Shafique

Bukhari

Kumar

et al. 2022

Int. j. endorsing health sci. res.

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Background: Glomerular diseases are a universal health issue, and Pakistan ranks eighth in renal disease, causing 20,000 deaths every year. Renal biopsy is a valuable diagnostic tool and provides prognostic insight and therapeutic plans. The study's objective is to determine the frequency and pattern of various glomerulopathies concerning age and gender. Methodology: A cross-sectional study was performed at the Department of Pathology, Ziauddin Medical University, and Hospital, Karachi, from 19th December 2018 to 15th April 2019. A total of 91 patients were included of either gender with a clinical history of glomerulonephritis. All biopsy samples were analyzed by using light and immunofluorescence microscopy techniques. Patient data were compiled and analyzed through SPSS version 20.0. Results: A total of 91 cases of the renal biopsy were evaluated; 51.6% of these cases were male patients. Forty-nine (53.8%) cases were reported as focal segmental glomerulosclerosis, 35(38.5%) were diagnosed with membranous glomerulonephritis, and 7(7.7%) were reported as mesangiocapillary glomerulonephritis. In membranous glomerulonephritis, 7.7% were pre-spike membranous glomerulonephritis. In the current study, 35.2% of cases showed diffuse glomerular basement membrane (GBM) thickening with spikes, and 4.4% showed GBM thickening with focal spikes on silver stain. Conclusion: Glomerular diseases are slightly more prevalent in males than females. The most commonly diagnosed primary glomerulonephritis was focal segmental glomerulosclerosis, followed by membranous glomerulonephritis.

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Section: Discussionsupporting

confidence: 93%

“…al. (27.7%)15 and Hashmi et al (33.6%)16 . Outside Pakistan, it is reported by Hamilton et al in the United Kingdom (11.4%)17 and Hu et al 24.96% in China18 .…”

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confidence: 91%

Morphological Audit of glomerular diseases in a tertiary care Hospital.

Shafique

Bukhari

Kumar

et al. 2022

Int. j. endorsing health sci. res.

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“…Glomerular diseases are one of the most important insidious sources of chronic renal failure [1]. Although primary glomerulopathies remain an important cause [2], most of the cases result from secondary etiologies among which diabetes and systemic lupus erythematosis (SLE) are in top of the list. Renal involvement in SLE is sometimes not readily apparent leading to late presentation and poor outcome.…”

Section: Introductionmentioning

confidence: 99%

Spectrum of Morphologic Features of Lupus Nephritis According to Nephrology/Renal Pathology Society (ISN/RPS) Classification

Hashmi

Ali

Rahman

et al. 2020

Cureus

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Introduction Lupus nephritis is one of the most important secondary glomerulopathy and a significant cause of chronic renal failure. Early diagnosis is key to improved prognosis. The International Society of Nephrology/Renal Pathology Society (ISN/RPS) classification stratifies renal biopsy evaluation in different classes that correlates with clinical renal outcome. In the current study, we aimed to evaluate the proportion of patients in each class of lupus nephritis in our population. Methods We evaluated renal biopsies of 128 patients that fulfilled the clinical and serologic criteria of lupus nephritis. The histologic classification was done according to the ISN/RPS classification, and immunofluorescence studies were performed. Active and chronic lesions were assessed on renal biopsy, and association of different histopatholgic parameters with lupus classes was done. Results The mean age was 28.85±12.24 years. Most of the patients were from age group ≤25 years (48.4%). Active lesions were seen in 66 (51.6%) patients, with endocapillary hypercellularity being the most common active lesion type, i.e. 81.8%. Chronic lesions were noted in 42 (32.8%) patients, with glomerular sclerosis being the most common chronic lesion type, i.e. 69%. Majority of the patients belonged to class IV (46.9%). Females were more likely to present at advanced lupus stage compared to males, and older patients (>50 years) had a higher chance to present at a late stage (class IV and higher). Active lesions were significantly found more frequently in classes III and IV, while chronic lesions were more likely to present in classes III to V. Conclusion We found that a significant proportion of patients of lupus nephritis in our population presents at an advanced stage as more than 60% patients were of class IV or higher. This signifies lack of appropriate clinical surveillance of patients and assessment of renal functions early in disease course. This also necessitates revision of our locoregional protocols to manage lupus nephritis patients and a need to perform a renal biopsy early in disease course.

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“…In our study cohort, we found an increased number of FSGS (30.9%) and membranous glomerulonephritis (23.5%), highlighting the need for further research to find the prevalence of associated variables such as hepatitis B and HIV infections in at-risk populations [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Morphological Spectrum of Glomerulonephritis in Medical Renal Biopsies: A Single-Center Study

Rafique¹,

Sadaf²,

Batool³

et al. 2022

Cureus

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BackgroundGlomerulonephritis is among the most common and serious non-communicable diseases in the world, and some of them are major causes of chronic kidney disease, which eventually leads to kidney failure. In developing countries, it is the most common cause of end-stage renal disease (ESRD). Chronic kidney disease affects 10-16% of the adult population in Asia, including 21.2% in Pakistan. This study aims to determine the frequency and spectrum of glomerulonephritis at our center. MethodologyThis is a cross-sectional analysis of 81 renal core biopsies obtained between August 2020 and August 2021. The histopathological reports, demographic data, and relevant laboratory investigations, such as blood urea and creatinine levels, were collected. All cases were blindly reviewed by two pathologists with a special interest in medical renal pathology. Data were analyzed using SPSS version 22 (IBM Corp., Armonk, NY, USA). ResultsThe majority of the patients (46.9%) were between the ages of 21 and 40 years. There was a slight male predominance, with 44 (54.3%) of the 81 participants being male. Hematuria was reported in 20 (24.7%) patients, with mean serum urea and creatinine levels of 75 mg/dL and 2.6 mg/dL, respectively. Nephrotic syndrome was the most common indication for a renal biopsy, accounting for 54 (67.7%) of the 81 cases. Chronic glomerulonephritis is classified into two categories, namely, primary and secondary glomerulonephritis. Focal segmental glomerulosclerosis (FSGS), the leading cause of primary glomerulonephritis, was found in 25 (30.9%) 81 patients. Furthermore, lupus nephritis (9.9%) and advanced glomerulonephritis (9.9%) were found in equal proportions among secondary glomerulonephritis. ConclusionsAccording to our study, nephrotic syndrome was the most common indication for medical renal biopsy, with FSGS being the most common primary glomerulonephritis. Lupus nephritis and advanced glomerulonephritis were the most common secondary glomerulonephritis diagnoses.

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Insight to changing morphologic patterns of glomerulopathy in adult Pakistani patients: an institutional perspective

Cited by 8 publications

References 19 publications

Morphological Audit of glomerular diseases in a tertiary care Hospital.

Morphological Audit of glomerular diseases in a tertiary care Hospital.

Spectrum of Morphologic Features of Lupus Nephritis According to Nephrology/Renal Pathology Society (ISN/RPS) Classification

Morphological Spectrum of Glomerulonephritis in Medical Renal Biopsies: A Single-Center Study

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