ABSTRACT
Background: In developing countries like India, thecauses for end stage renal failure has been changingwith glomerular diseases occupying an important place.The trend of various primary and secondary causes ofNephrotic Syndrome (NS) over the past few decadeshas been debatable especially with reference togeographical locations. Aim and Objectives: This studywas intended to find out the histologic patterns ofglomerular disease associated with NS in South Indiaand analyze the corresponding clinical and biochemicalabnormalities associated with these conditions.Material and Methods: One hundred eighty eightpatients in the age group of 18-80 years with NS whounderwent renal biopsy between the periodst thfrom1 January 2018 to 30 September 2019 wereincluded in this study. Baseline investigations and otherinvestigations related to renal profile evaluationincluding complement levels and HIV antibody weredone. Results: Focal Segmental Glomerulosclerosis(FSGS) accounted for the majority (25.5%) amongprimary glomerular diseases while among thesecondary glomerular diseases Lupus Nephritis (LN)(51.19%) constituted the majority and a substantialcontribution from Human Immunodeficiency VirusAssociated Nephropathy (HIVAN). LN was seen onlyin female patients with a mean age of 33.36 ± 10.74years. Among LN, Class III was the most predominantwhile Class IIIC was less frequent. C3 and C4complement levels were less than normal in Class IVand Class variants of LN. Conclusion: This studyhighlights the spectrum of Lupus Nephritis and HIVassociated nephropathy as a cause for adult NS in atertiary care center in South India
ABSTRACT
Percutaneous renal biopsy is an essential component for diagnosis and management of glomerular diseases. In order to elucidate clinical and pathological features, 494 renal patients who had undergone renal biopsies at Gil Medical Center from January 1989 to June 1999 were studied retrospectively. The male to female ratio was 1.3 : 1 and average age was 33.2 years. There were 370(83.5%) cases of primary glomerular disease and 58(13.1%) cases of secondary glomerular disease. Among primary glomerular disease, IgA nephropathy was the most common(175 cases), followed by minimal change disease(84 cases), membranous glomerulonephritis(34 cases), and focal segmental glomerulosclerosis(33 cases). In secondary glomerular disease, lupus nephritis was the most common(21 cases), followed by 11 cases of hepatitis B associated glomerulonephritis, 9 cases of Henoch-Sch nlein purpura, and 4 cases of diabetic nephropathy. Among 99 cases of asymptomatic urinary abnormalities, IgA nephropathy was most common(69 cases) followed by 12 cases of thin basement membrane disease, 4 cases of minimal change disease, and 3 cases of focal segmental glomerulosclerosis, membranous glomerulonephritis, nonspecific glomerulonephritis. Among 159 cases of nephrotic syndrome, minimal change disease was most common(60 cases) followed by 25 cases of IgA nephropathy, 23 cases of focal segmental glomerulosclerosis, 21 cases of membranous glomerulonephritis, and 13 cases of lupus nephritis. Documented complication of renal biopsies included 23 cases of gross hematuria, 6 cases of perirenal hematoma, and 4 cases of infection. Death, AV fistula, aneurysm or serious compications that required surgical intervention were not reported. In conclusion, the percutaneous renal biopsy is relatively safe, and useful for diagnosis and management of glomerular diseases. The most common type of primary glomerular disease was IgA nephropathy.