Spectrum of Biopsy Proven Renal Diseases (BPRD): A Single Center Experience

Abstract

Kidney biopsy is one of the most important tools in the assessment of kidney disease as histopathological diagnosis promotes evidence based practice in Nephrology. This is a study was done by including all consecutive percutaneous kidney biopsies (273; Males:147, Females: 126) performed at EMS Memorial Cooperative Hospital, Perinthalmanna, Kerala, India, from September 2009 to February 2016. Among the biopsy proven renal diseases (BPRD); primary glomerular diseases (PGD) were the commonest (78.39%) followed by secondary glomerular diseases (SGD) (12.45%) and tubulointerstitial diseases (TID) (9.16%). The IgA Nephropathy (IgAN) was the commonest PGD and majority had mesangial hypercellularity (M1) (93.54%), tubular atrophy (T1 or T2 67.74%) and the most common pattern was M1, E0, S0, T1, suggesting that patients of Indian subcontinent have aggressive disease type; unlike western literature. The focal segmental glomerulosclerosis (FSGS) was the second commonest PGD and majority were of not otherwise specified (NOS) type. FSGS, membranous nephropathy (MN) and minimal change disease (MCD) were the 3 most common causes for PGD causing nephrotic syndrome. Diabetic nephropathy and lupus nephritis (LN) were the two most common biopsy proven SGD. Among the patients of diabetes mellitus (DM) who underwent renal biopsy with suspicion of non-diabetic renal disease (NDRD); 58.33% had NDRD, 16.67% had DN+ NDRD and 25% had DN alone. This study the changing pattern BPRD in comparison to earlier studies. This study also, confirms the aggressive nature of IgAN in Indian patients and underlines the importance of renal biopsy in patients of DM.