Kidney biopsy in subsaharan Africa

Abstract

We carried out a retrospective and descriptive study on biopsies examined between January 2015 and December 2019, in the pathological departments of University Teaching Hospital of Bouaké and Cocody-Abidjan. The KB came from four countries (Côte d'Ivoire, Togo, Guinea-Conakry and Burkina Faso). Optical microscopy and/or direct immunofluorescence techniques were used. All biopsy samples including epidemiological, clinical and pathological data and an optical microscopy and/or direct immunofluorescence study were included. The parameters studied were indications for KB, epidemiological profile, clinic, proteinuria and pathological aspects. Over the study period, we collected 179 KB, i.e. 35.8 KB/year. The mean age of the patients was 32.9 ±13.8 years (range 11-70 years). The sex ratio (M/F) was 1.03. Pure nephrotic syndrome was the main indication (64.2%, n = 115) for KB, followed by impure nephrotic syndrome (11.7%, n = 21), acute renal failure (ARF) (7.8%, n = 14) and rapidly progressive glomerulonephritis (RPGN) (7.8%, n = 14). Glomerulonephritis (GN) occurred in 86% (n = 158), vascular nephropathy in 11.7% (n = 21) and tubulointerstitial nephritis in 2.2% (n = 4). The nephropathies were preferentially focal segmental glomerulosclerosis (34.6%, n = 62), nephroangiosclerosis (10.6%, n = 19), membranous GN (10%, n = 18), post-infectious GN (8.9%, n = 16) and lupus GN (7.3%, n = 13). The KB is an essential step in the diagnosis of nephropathies. Focal segmental glomerulosclerosis is frequent in our study. The establishment of a Kidney registry would allow better knowledge of renal pathologies in sub-Saharan Africa.