A clinicopathologic study of glomerular disease: A single-center, five-year retrospective study from Northwest India

Abstract

Studies published from centers across India have reported different and contradicting patterns of glomerular disease. In this retrospective study, we report our experience from a Tertiary Care Center in Northwest India. A total of 702 renal biopsies performed between 2008 and 2013 were reviewed of which 80 were excluded from the study because of having insufficient records or if the biopsies were taken from an allograft. The study included 411 males (66.1 %) and 211 females (33.9%) with an age range of 12-70 years (mean 30.34 ± 7.04 years). Majority of the biopsies (93.9%) showed some form of glomerulonephritis (GN), either primary (79.4%) or secondary glomerular disease (SGD) (14.5%). Minimal change disease (MCD) was the most common type of primary GN (26.5% of primary GN), followed by membranous nephropathy (MN; 18.8%) and focal and segmental glomerulosclerosis (FSGS; 13.2%). Lupus nephritis (LN) was the most frequent SGD (52.2% of secondary GN). Amyloidosis was found in 41.1% and diabetic glomerulosclerosis in 4.4%. LN was also the second most common diagnosis in females after MCD, seen in 19.4% of females. MCD followed by membranoproliferative GN and diffuse proliferative GN were the most common entities in individuals <20 years of age. In the 20-39 years age group, MN was the most common pathology seen. MN was again the most common pathology seen in patients aged above 40 years followed by amyloidosis and FSGS. In this study, MCD was the most common primary GN observed overall from this part of India. MN was the most common GN in individuals above 20 years of age presenting with the nephrotic syndrome. The geographical and regional differences in the pattern of GNs point to the necessity of having a central biopsy registry.

Adult glomerular diseases in east zone and zonal prevalence in India: an Omnium Gatherum

“…There are regional variations as well as change in the spectrum of kidney diseases over time as is seen in registry data from various parts of the world. 2,6,14 A similar change in the spectrum of GD over the last few decades was demonstrated in many studies worldwide, most showing a trend towards FSGS prevalence. [15][16][17][18][19][20] Indian data too showed changing spectrum of prevalent GD.…”

“…22,23 In West India, MCD was reported as the commonest primary GD by Beniwal et al whereas, Golay et al and Jamil et al reported MCD prevalence in East India. 7,14,33 In comparison, our study from East India showed IgAN as the prominent primary GD followed by FSGS.…”

“…22 Our study reported DN as the second most prevalent secondary GD, concordant with various Indian studies whereas, certain other Indian data revealed DN as the dominant secondary GD. 3,5,8,10,11,14,22 This variability is because of the prevalence of diabetes in those parts of India. Similar variability in prevalence of secondary GD has been world-over where LN was common in Chinese, Korean and European studies, while DN predominated in data from Czech Republic, Japan, and Scotland.…”

The Genetic and Environmental Factors of Primary Membranous Nephropathy: An Overview from China

“…An increasing trend of pMN has been observed in many developing countries, such as Pakistan [96], Czech Republic [97], and India [98, 99]. The frequency of pMN in India increased almost by 2-fold during 1999–2008 [98, 99].…”

“…The frequency of pMN in India increased almost by 2-fold during 1999–2008 [98, 99]. In an Indian cohort with high-concentration exposure to PM 2.5 , during the period of 1971–2002, there was a steady increase in pMN prevalence [100].…”