Mon-031 Older Individuals Undergoing Native Kidney Biopsies: Trend Over 10 Years in an Urban Southeast Asian Center

Abstract

Introduction: Glomerular disease associated with wide variety of biochemical disturbance and pathophysiological alteration in human body. It is a leading cause of chronic kidney disease in developing countries. In Bangladesh prevalence of CKD and ESRD increasing mostly due to glomerulonephritis. Presentation of glomerular disease ranges from asymptomatic to life threatening acute complications-AKI and also CKD.The prevalence of glomerular disease is different in various regions of the world and varies depending on the race, age, geographical, etiological, cultural and economic characteristics. This study reflects pattern of glomerular disease and their clinicopathological and histological characteristics in Bangladeshi population. Methods: This study has been conducted at department of nephrology, Shaheed Suhrawardy Medical College hospital, Dhaka from January 2017 to June 2018. 206 patients of glomerular disease was included in the study with proteinuria >0.5gm/day or presence of RBC or RBC cast in urine and /or renal impairment. Selected patients were evaluated both clinical history, examination and investigations. After taking consent renal biopsy was performed and histopathology (light microscopy and DIF) done by expert pathologist. All data recorded in case report form (CRF). Data were analyzed by using SPSS software. Results: Total 206 patients included in the study with mean age 34.5AE14.13 years, female were more than male (61.5%). More than 50% patients were in less than 40 years. Most common presentation was edema (87.2%), others were hypertension, anemia, reduced urine, hematuria, shortness of breath, arthritis, skin rash, sore throat and renal failure. Histologically Mesangial Proliferative Glomerulonephritis was more common variety of Glomerulonephritis (34.3%). Others were Lupus Nephritis (15%), Membranoproliferative (12.1%), FSGS (11.6%), IgA nephritis (5.8%), MCD (5.3%), Membranous Nephropathy (3.9%) and IgM nephropathy (2.9%). FSGS and IgM glomerulonephritis male were more affected than female, in MesPGN, LN, MPGN and IgA glomerulonephritis female were more affected than male. Patient with FSGS, MPGN, MesPGN and LN were hypertensive. Common age of MCD was 10-20 years, in FSGS >50% presented in 21-40 years, membranous glomerulonephritis 21-40 years, membranoproliferative glomerulonephritis 21-50 years, mesangial proliferative glomerulonephritis 10-50 years, lupus nephritis 10-40 years age, IgA nephritis10-50 years, IgM 10-30 years of age respectively. Mean UTP 4.24AE3.17 gm/day. >50% of FSGS, MGN, MpGN, MesPGN and MCD patients had more than 3gm/day proteinuria. 50.49% glomerulonephritis was associated with increase serum creatinine. Mesangial proliferative, membranoproliferative glomerulonephritis, FSGS, Membranous Nephropathy, Lupus Nephritis and IgA nephropathy associated with renal impairment. Conclusions: Histological pattern of glomerulonephritis may vary from different geographical area. In our study Mesangial proliferative glomerulonephritis was most common variety of glomerular disease.FSG...