Spectrum of biopsy-proven kidney diseases at a tertiary care hospital in South India

Abstract

Introduction The prevalence of kidney diseases, glomerular and tubulointerstitial, varies with the geographical area, socioeconomic conditions of the people, population demographics, race and ethnicity, access to health care, and also the threshold for doing a renal biopsy. Objective The primary objective was to study the prevalence of biopsy-proven kidney diseases presenting to a tertiary care hospital in Mysore, South India. Patients and methods We have retrospectively analyzed the renal biopsy data from 2005 to 2013. The clinical and laboratory data of patients were collected from biopsy request forms, and histopathology data were recorded. Biopsy specimens were examined by light and immunofluorescence microscopy. As a hospital policy, all biopsies were based on definite indications. A total of 1113 biopsies were considered. Transplant biopsies and those with inadequate specimen were excluded. Results A total of 914 patients had some kind of glomerulopathy. Minimal change disease (n=182/1113) was the commonest histological type among glomerular diseases, followed in order by postinfectious glomerulonephritis, focal segmental glomerular sclerosis, membranous glomerulopathy, and immunoglobulin A nephropathy. Among the secondary glomerular diseases, the commonest was diabetic nephropathy (n=72) followed by lupus nephritis (n= 58) and crescentic glomerulonephritis. Most common indication for renal biopsy was nephrotic syndrome (n=274/1113), chronic kidney disease (n=141), acute glomerulonephritis (n=107), acute kidney injury with unclear etiology or delayed recovery, and rapidly progressive glomerulonephritis. Conclusion Nephrotic syndrome was the commonest indication for renal biopsy, and minimal change nephrotic syndrome (MCNS) was the most common glomerular disease followed by focal segmental glomerular sclerosis. Membranoproliferative glomerulonephritis, the incidence of which has decreased in the developed world, still accounts for a significant number in our population. There is a need for electronic data monitoring in India with nationwide integration for a proper analysis of the changing trends of diseases occurring over an extended time frame.