Pattern of glomerular diseases in a tertiary care center in south India: A prospective study

Jeganathan, Jayakumar; Kumar, Sampath; Maroli, Chakrapani

doi:10.4103/1319-2442.106363

Cited by 7 publications

(10 citation statements)

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Section: Introductionmentioning

confidence: 99%

“…2 Lupus nephritis (LN) is the most severe form of organ damage in patients with SLE and one of the most common secondary glomerular diseases, accounting for approximately 70% of secondary glomerular diseases based on histopathological examination. 3 Importantly, LN frequently remains unrecognized until it has developed into full-blown nephritic and/or nephrotic syndrome with renal failure. 4 Changes in several indicators, including the presence or increase of protein in the urine, positive autoantibodies, and decreased hemoglobin and complement levels, may reflect SLE disease activity and renal damage.…”

Section: Introductionmentioning

confidence: 99%

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Clinical aspects and risk factors of lupus nephritis: a retrospective study of 156 adult patients

et al. 2019

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Objective To analyze the clinical manifestations, laboratory indexes, disease activity, and pathological types of lupus nephritis (LN) in adult patients. Methods We retrospectively analyzed the clinical manifestations, laboratory indexes, and pathological classifications of 156 adult patients first diagnosed with LN between July 2013 and November 2017. Patients were categorized according to the following criteria: active or inactive LN, LN with or without renal damage, and mild or severe LN. Results Immunoglobulin G and A levels, 24-hour proteinuria, and anti-dsDNA, anti-Sm, and anti-ribosomal P protein antibody positivity rates were all significantly increased in patients with active LN compared with inactive LN. Anti-dsDNA antibody positivity and 24-hour proteinuria were significantly increased, whereas hemoglobin, serum albumin, and C3 and C4 levels were significantly decreased in patients with LN and renal damage compared with those without renal damage. Anti-dsDNA and anti-Sm antibody positivity rates and 24-hour proteinuria were significantly increased, while hemoglobin, serum albumin, C3 and C4 levels, and estimated glomerular filtration rate were significantly decreased in patients with severe LN compared with patients with mild LN. Conclusions LN can display various clinical manifestations, laboratory indexes, levels of disease activity, and pathological types in adult patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical aspects and risk factors of lupus nephritis: a retrospective study of 156 adult patients

et al. 2019

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“…Similarly, proteinuria as a clinical syndrome was the major indication for doing renal biopsies in all the Indian studies with each study showing prevalence of different GD, as discussed above. [3][4][5][6][7][8][9][10][11]14,[21][22][23]32,33 The second commonest clinical syndrome for doing renal biopsies was EyRD (39.3%), incidence similar to data from AIIMS by Agarwal et al and from Rohtak. 5,11 CIN was the commonest cause of EyRD in our study [43.8%], as also reported from Madras whereas it was reported as the third commonest cause of CKD from Rohtak, Chandigarh and Lucknow.…”

Section: Discussionmentioning

confidence: 55%

“…5,6,8,11 In South India, FSGS was reported as the commonest primary GD from CMC Vellore whereas MCD was reported from Hyderabad and Mangalore (followed by IgAN). 3,4,32 Another prominent centre from South India reported a changing trend in primary GD prevalence, with IgAN leading the pack, followed by FSGS. 22,23 In West India, MCD was reported as the commonest primary GD by Beniwal et al whereas, Golay et al and Jamil et al reported MCD prevalence in East India.…”

Section: Discussionmentioning

confidence: 99%

“…A higher prevalence of IgAN in India in areas with higher literacy and better hygiene is seen in other Indian studies and translates into the pattern seen in developed countries. 22,23,32 The authors submit that another reason for high detection of IgAN in recent studies is the lower threshold for renal biopsies for want of definitive diagnosis in patients with unexplained early renal dysfunction with normal sized kidneys irrespective of proteinuria.…”

Section: Discussionmentioning

confidence: 99%

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Adult glomerular diseases in east zone and zonal prevalence in India: an Omnium Gatherum

Dogra

Shanmugraj

Jana

et al. 2019

Int J Community Med Public Health

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Background: India is a vast country with four geographical zones. Zonal heterogeneity amongst prevalent adult glomerular diseases is expected and has not been analysed in past studies.Methods: We conducted clinico-histological correlation of 290 kidney biopsies for adult glomerular diseases (GD) at tertiary teaching hospital in Eastern India between January 2013 and December 2015 and compared our data with biopsy data from other geographical zones in India to evaluate zonal variability (intra/inter) of adult glomerular diseases.Results: Males dominated all clinical syndromes except subnephrotic proteinuria (SbNP). IgA Nephropathy (IgAN, 41.1%) and Focal Segmental glomerulosclerosis (FSGS, 17.3%) were prevalent primary GD whereas Lupus nephritis (LN, 52.2%) and diabetic nephropathy (DN, 23.9%) were prevalent secondary GD. IgAN (44.4%) and LN (33.2%) dominated SbNP group whereas FSGS (30.2%) and Membranous nephropathy (MGN, 22.3%) dominated nephrotics. Mean eGFR (CKD-EPI) amongst EyRD and RPRF was 39.6±12.9 and 6.2±2.9 ml/min/1.73m2 respectively. In contrast, biopsies from East India showed MCD prevalence, followed by FSGS. Kidney biopsy data from West India showed MCD prevalence whereas Northern India and South India studies showed FSGS and MCD prevalence, but later data showed an IgAN emergence, as in our data.Conclusions: There is considerable heterogeneity in prevalent adult glomerular diseases in different geographical zones (inter and intra) in India. FSGS and MCD were the most prevalent in all zones. Our study showed IgAN prevalence in East Zone, similar to South India. Reason was, increased number of kidney biopsies in EyRD (eGFR 30-60 ml/min) and subnephrotic proteinuria.

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Protocol and rationale for the first South Asian 5-year prospective longitudinal observational cohort study and biomarker evaluation investigating the clinical course and risk profile of IgA nephropathy: GRACE IgANI cohort

Schmeißer¹,

John²,

Korula³

et al. 2018

Wellcome Open Res

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Background: IgA nephropathy (IgAN) is the most common primary glomerulonephritis and an important cause of end-stage kidney disease. Unlike the slowly progressive course seen among Caucasian and East Asian subjects (actuarial survival 80-85% over 10 years), in India about 30-40% of patients have nephrotic syndrome and renal dysfunction at presentation and a 10-year renal survival of 35%, as reported from a retrospective registry. These observations cannot be entirely attributed to a lack of uniform screening protocols or late referral and attest to the probability that IgAN may not be the same disease in different parts of the world. Methods: We will prospectively recruit 200 patients with IgAN (the GRACE IgANI— Glomerular Research And Clinical Experiments- Ig A Nephropathy in Indians—cohort) and stratify them into low and high risk of progression based on published absolute renal risk scores. We will test the validity of this risk score in an unselected Indian IgAN population over a 5-year follow-up period. In parallel, we will undertake extensive exploratory serum, urine, renal and microbiome biomarker studies, firstly, to determine if the underlying pathogenic pathways are the same in Indian IgAN compared to those reported in Caucasian and East Asian IgAN. Secondly, we will systematically assess the value of measuring selected biomarkers and adding this data to traditional measures of risk in IgAN to predict kidney failure. We ultimately hope to generate a composite IgAN risk score specific for the Indian population. Ethics and data dissemination: Approval was obtained from the Institutional Review Board (Silver, Research and Ethics Committee) of the Christian Medical College, Vellore, India (Ref. No. IRB Min. No. 8962 [Other] dated 23.07.2014 and IRB Min. No. 9481 [Other] dated 24.06.2015). It is anticipated that results of this study will be presented at national and international meetings, with reports being published from late 2018.

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Pattern of glomerular diseases in a tertiary care center in south India: A prospective study

Cited by 7 publications

References 0 publications

Clinical aspects and risk factors of lupus nephritis: a retrospective study of 156 adult patients

Clinical aspects and risk factors of lupus nephritis: a retrospective study of 156 adult patients

Adult glomerular diseases in east zone and zonal prevalence in India: an Omnium Gatherum

Protocol and rationale for the first South Asian 5-year prospective longitudinal observational cohort study and biomarker evaluation investigating the clinical course and risk profile of IgA nephropathy: GRACE IgANI cohort

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