Histopathological Spectrum of Renal Lesions in Adults with Proteinuria.

ABSTRACT

Background and Objectives: Proteinuria of more than 2.0 g in 24 hours is indicative of renal disease and a value of more than 3.5 g is a component of Nephrotic syndrome. The pathology resulting in proteinuria can be glomerular, tubular and others. Renal biopsy is gold standard in evaluation and management of patients with proteinuria especially Nephrotic syndrome. Methods: A retrospective analysis of all renal biopsies from adult patients with significant proteinuria over a period of 4 years was performed to study the pattern of renal pathology. The morphological findings were correlated with Clinical findings, laboratory findings &Immunofluorescence profile as per availability. Results: It was observed that clinical diagnosis matched the final pathological diagnosis in 79 (58.09%) cases. Further, Light Microscopy findings corresponded with Immunofluorescence in 142 out of 158 cases, while the diagnosis was changed in 16 (10.13%) cases after IF. Conclusions: The results thus indicate that renal biopsy along with IF plays an important role in diagnosis of cases with significant proteinuria a fact highlighted by low concordance % between the clinical and the pathological diagnosis. An accurate diagnosis is not only essential to initiate appropriate therapy but also in prognostication of renal lesions.