Study of paediatric renal biopsies with clinicopathologic correlation and comparison with literature on adult renal biopsies

Abstract

Introduction: Renal biopsy is frequently used in complete work-up for renal diseases. The kidney reacts in a limited number of patterns to various injuries and the clinical manifestations corresponding to these reactions are also limited. Aim of the study: To study the non-neoplastic renal diseases in paediatric population 0-15 year age, to study the differences in the disease prevalence between paediatric and adult population, and to document the geographic variation in renal diseases. Materials and Methods: The renal biopsies from 0-15 year age group of both genders were studied for light microscopy and immunofluorescence studies. The clinical presentation of the patients such as nephrotic or nephritic or both or as acute renal failure was noted for clinic pathologic correlation. The paediatric renal diseases were compared with adult renal diseases based on literature search. Also the geographic variations were studied and compared based on published data from different countries. Results: Nephrotic syndrome was the most common clinical presentation for paediatric renal diseases .Minimal change disease (37.8 %) and FSGS (22.4 %) cases commonly presented as nephrotic syndrome. PIGN (37.6 % cases) presented frequently as nephritic syndrome in the paediatric age group. Conclusion: Nephrotic syndrome is the most common indication for renal biopsy and minimal change disease is the commonest cause of nephrotic syndrome in children. Incidence of membranous nephropathy and IgA nephropathy is relatively less in India. PIGN is the most common cause of acute renal failure in the paediatric age group. In systemic lupus erythematosus, most common presentation is nephrotic syndrome with class IV lupus nephritis being more frequent. Keywords: Acute renal failure, IgA nephropathy, Nephrotic syndrome, Nephritic syndrome, Paediatric age group, Renal biopsy.