Spectrum of Renal Parenchymal Diseases: An Eleven Year Retrospective Review of Renal Biopsy Data from a Tertiary Care Hospital in Pakistan

Abstract

<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>

Morphological Audit of glomerular diseases in a tertiary care Hospital.

“…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.…”

“…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 .…”

A Pattern of Glomerular Diseases in Egyptian Children: A Single-center Experience

“…Regarding the male to female ratio, this study agrees with a former retrospective review in which there was a higher male percentage than females (125 males [50.4%] and 123 females [49.6%]) [12].…”

Histomorphological Spectrum of Glomerulopathies: A Review

“…This may be because of nephrotic syndrome reported by the majority of the 29 studies as the only indication to perform a renal biopsy and as we noted in many studies these two patterns are the commonest cause of nephrotic syndrome [29][30][31][32] . We detected that there were very few studies 33 which distributed the glomerulopathy in primary and secondary diseases. The most common secondary glomerulopathy found was lupus nephritis [34][35] .…”