Histological patteren of nephrotic syndrome in elderly patients

Renal biopsy is a safe and informative technique that has played a key role in the evolution of nephrology as a specialty. This cross-sectional descriptive study was aimed to study the histological pattern of nephrotic syndrome in elderly patients. This study was conducted from January 1998 to December 2005 [8 Years] in the Department of Nephrology, Govt. Lady Reading Hospital, Peshawar, Pakistan. We performed renal biopsy in 153 patients aged 60 years and above, admitted with nephrotic syndrome-proteinuria with protein >3 gm/24 hours with or without oedema, hypoalbuminemia, hyperlipidemia, acute nephritic syndrome-red blood cell casts or dysmorphic red cells on urine microscopy, temporally associated with acute renal failure with or without new onset hypertension, acute renal failure-sudden decline in renal functions developing in days to weeks causing retention of nitrogenous wastes and rapidly progressive renal failure-sub acute decline in renal functions developing over weeks to months. Significant differences in the histological pattern are noticed when compared with the studies of the other centres. Minimal Change Disease [MCD] was the commonest histological pattern [40%], followed by Membranous Nephropathy [21%], Crescentic Nephritis [19.6%], Focal Segmental Glomerulosclerosis [FSGS] [6.5%], Hypertensive Nephropathy [5.8%], Messangiocapillary Glomerulonephritis [MCGN] [3.9%] and Diffuse Proliferative Glomerulonephritis [DPGN] [3.2%]

Early complications of percutaneous kidney biopsy during hospital stay

To evaluate the early complications of percutaneous kidney biopsy during hospital stay. This prospective study was performed in the Deptt of Nephrology, Lady Reading Hospital, Peshawar from September 2002 to June 2006. All patients meeting the criteria and undergoing percutaneous kidney biopsy were included in the study. Kidney biopsies were performed by experienced operators under local anesthesia with ultrasound guidance using 18 guage needle and spring loaded gun. Baseline FBC, haematocrit, coagulation profile, blood urea, serum creatinine, urinalysis and ultrasound were done before biopsy. Check ultrasound, FBC, haematocrit, 24 hour urine collection were obtained next morning. Total number of biopsies done during this period was 650. There were 400 [64%] males and 250 [36%] females, mean age was 38.5 years. Adequate sample [>10 glomeruli] were obtained in 97% cases. Over all hemorrhagic complications were observed in 4% [n=26] patients. Post biopsy bleeding was higher in females n=16 [61%] than males n=10 [28%]. Gross haematuria requiring blood transfusion was observed in 9 patients [1.3%]. Post kidney biopsy [24 hour] decline in HCT<10% was seen in 505 patient [78%] and>10% in 145 patients [22%]. After the procedure, 630 patients [97%] were discharged next morning. Percutaneous kidney biopsy using 18 gauge needle and automated spring loaded gun is a safe technique with minimal complications and adequate tissue sampling

Renal biopsy in elderly patients -aged 60 years and olders

To study the histological diagnosis of renal biopsy in elderly patients - aged 60 years and older at Govt. Lady Reading Hospital, Peshawar Prospective study. Department of Nephrology, Govt. Lady Reading Hospital, Peshawar. Study was conducted from January 1998 to December 2005. We peformed renal biopsy in 153 patients, aged 60 years and older from multiple reference centers. Significant differences in the disease spectrum were found in the elderly population when compared with the studies of the other developed centers. Minimal Change Disease [MCD] was the most common diagnosis in the patients aged 60 years and older [40%], followed by Membranous Nephropathy [21%], Crescentic Nephritis 19.6%, Focal Segmental Glomerulosclerosis [FSGS; 6.5%], Hypertensive Nephropathy [5.8%], Messengiocapillary Glomerulonephritis [MCGN; 3.9%] and Diffuse Proliferative Glomerulonephritis [3.2%]