Analysis of Clinical and Histopathological Pattern of Biopsy Proven Glomerular Diseases from Central India.

Abstract

The pattern of glomerular disease differs in incidence among the different geographical areas because of ethnicity, genetic variability, environmental factors, and socioeconomic conditions. The prevalence of pattern glomerular diseases varies from different parts of the world and from within the same country, the current study was performed to show the frequency of occurrence of primary and secondary glomerular disease (SGD) observed in a tertiary care hospital catering to patients from central India. In a retrospective study, we analyzed the clinical and pathological data of 176 kidney biopsies that were performed from 2016 to 2019 at the Department of Nephrology Super Speciality Hospital in Nagpur. Ultrasound-guided kidney biopsies were performed percutaneously using an automated gun. The biopsy samples were examined for light microscopy and immunofluorescence. Patient age, gender, blood urea, serum creatinine, urine microscopy, 24-h urinary protein, virology, immunology profiles, indication for kidney biopsy, and histopathological findings were recorded for analysis. In our study, the most common indication for kidney biopsy was nephrotic syndrome (63.6%) followed by systemic lupus erythematosus with lupus nephritis (LN) (25.5%). Primary glomerular disease (PGD) was reported in 70%, SGD was reported in 30% of the 176 kidney biopsies studied. Among the 124 patients with PGD focal and segmental glomerulosclerosis (FSGS) was most common (30.6%) followed by primary membranous glomerulopathy (18.5%), minimum change disease (17.7%), immunoglobulin A nephropathy (10.4%), C3 glomerulopathy (5.6%), and diffuse proliferative glomerulonephritis (4.8%). Among the patients with SGD, LN was the most common (86.5%) followed by AL amyloidosis (3.4%) and AA amyloidosis (3.4%). In our study, among the PGD, FSGS was the most frequent while LN was the most common SGD.