Clinicopathological study of Pigment Induced Nephropathy: A retrospective study

Abstract

Introduction: Rhabdomyolysis and haemolysis cause pigment nephropathy that progresses to Chronic kidney disease requiring haemodialysis in some patients. As this is a significant financial burden, an understanding of the aetiologies and renal biopsy findings aids in timely diagnosis and optimising the outcomes. Objectives: We analysed the aetiology, clinicopathological features and renal outcome of seventeen patients with pigment nephropathy. Methodology: This Retrospective study was conducted from 2018-2021. Data on detailed clinical history, lab parameters, renal biopsy records, and renal outcome was collected. Results: Among seventeen pateints with Pigment Nephropathy the etiology was rhabdomyolysis in fifteen patients and hemolysis in two patients. Oliguria was the most common clinical presentation and all patients presented as acute kidney injury (AKI). Renal biopsy revealed reddish beaded granule and vermiform like casts in 10, brownish casts with intratubular hemosiderin in 3, granular and calcific casts in 2 patients each. While fourteen patients recovered to normal renal function within 3 months, one progressed to Chronic Kidney Disease stage 5D(CKD), one had CKD stage 2 and one died. Conclusion: In a majority of patients, clinical history did not reveal a direct diagnosis of rhabdomyolysis, and hence one must remain vigilant even in the absence of the classical triad of symptoms.