Clinicopathological profile of pediatric renal biopsies at a tertiary care hospital, Pakistan

Asim, Sadaf Ahmed; Khemchand, Moorani N; Lateef, Fouzia; Asia, Zubair

doi:10.4103/1319-2442.248290

Cited by 7 publications

(10 citation statements)

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“…In our study, primary glomerulopathies were predominant as compared to secondary. Our findings are in agreement with other researches 6,13 .…”

Section: Discussionsupporting

confidence: 94%

“…In the current study, males were outnumbered by females. Similar results were reported in other national local studies 6,13 (56.5% males and 43.5% females), (56% males and 44% females) and Indian study 14 (68.75% males and 31.25% females). These findings highlight that glomerular diseases make significant weight for males.…”

Section: Discussionsupporting

confidence: 91%

“…Multiple other etiologies include prolonged acute renal failure (ARF), rapidly progressive renal failure (RPRF), systemic disease with renal dysfunction, nonnephrotic proteinuria, isolated microscopic hematuria, unexplained renal failure, renal transplant dysfunction, and familial renal disease 4 . Primary glomerulopathies accounted for the commonest type of all kidney biopsies, the lowest 42.6% in Malaysia 5 and highest 94.4% in Pakistan 6 . Focal segmental glomerulosclerosis (FSGS) was the most frequent pattern of primary glomerular disease worldwide, with the lowest incidence as 18.2% in India 7, whereas the highest reported incidence was 59% in Saudi Arabia 8 .…”

Section: Introductionmentioning

confidence: 99%

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Morphological Audit of glomerular diseases in a tertiary care Hospital.

Shafique

Bukhari

Kumar

et al. 2022

Int. j. endorsing health sci. res.

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Background: Glomerular diseases are a universal health issue, and Pakistan ranks eighth in renal disease, causing 20,000 deaths every year. Renal biopsy is a valuable diagnostic tool and provides prognostic insight and therapeutic plans. The study's objective is to determine the frequency and pattern of various glomerulopathies concerning age and gender. Methodology: A cross-sectional study was performed at the Department of Pathology, Ziauddin Medical University, and Hospital, Karachi, from 19th December 2018 to 15th April 2019. A total of 91 patients were included of either gender with a clinical history of glomerulonephritis. All biopsy samples were analyzed by using light and immunofluorescence microscopy techniques. Patient data were compiled and analyzed through SPSS version 20.0. Results: A total of 91 cases of the renal biopsy were evaluated; 51.6% of these cases were male patients. Forty-nine (53.8%) cases were reported as focal segmental glomerulosclerosis, 35(38.5%) were diagnosed with membranous glomerulonephritis, and 7(7.7%) were reported as mesangiocapillary glomerulonephritis. In membranous glomerulonephritis, 7.7% were pre-spike membranous glomerulonephritis. In the current study, 35.2% of cases showed diffuse glomerular basement membrane (GBM) thickening with spikes, and 4.4% showed GBM thickening with focal spikes on silver stain. Conclusion: Glomerular diseases are slightly more prevalent in males than females. The most commonly diagnosed primary glomerulonephritis was focal segmental glomerulosclerosis, followed by membranous glomerulonephritis.

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“…In our study, primary glomerulopathies were predominant as compared to secondary. Our findings are in agreement with other researches 6,13 .…”

Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Morphological Audit of glomerular diseases in a tertiary care Hospital.

Shafique

Bukhari

Kumar

et al. 2022

Int. j. endorsing health sci. res.

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“…The sample size was calculated using OpenEpi online software based on an 8% margin of error and 95% confidence interval in a population of 4800 annual cases and 36.1% incidence. 10 A total of 135 cases with 35 cases of SRNS were required to achieve statistical significance. Once the required sample size was achieved, urinary β2-micro-globulin was checked by ELISA on the stored urinary samples from the presentation time using commercially available kits.…”

Section: Methodsmentioning

confidence: 99%

Can Steroid Response in Idiopathic Childhood Nephrotic Syndrome be Predicted? A Single Center Quasi-Experimental Study

Rehman

Ali

Ehsan

et al. 2022

PAFMJ

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Objective: To predict the role of clinical risk factors and urinary β2-microglobulin levels as a biomarker for steroid-resistant nephrotic syndrome. Study Design: Quasi-experimental study. Place and Duration of Study: Paediatric Nephrology Department, Sindh Institute of Urology and Transplantation, Karachi Pakistan, from Jun 2019 to Nov 2020. Methodology: All children (3 months to 12 years) with either first episode or relapse of the nephrotic syndrome were included. A stored urine sample was used on 100 patients with steroid-sensitive (group-1) and 35 patients with steroid-resistant nephrotic syndrome (group-2). In addition, histopathology of all patients with steroid-resistant nephrotic syndrome was recorded. Results: Both groups and those who had focal segmental glomerulosclerosis were compared and analysed to evaluate the predictability of steroid response. There was a significant association in both groups for microscopic haematuria, hypertension, heavy proteinuria (urine spot protein to creatinine ratio >10 g/g) and increased β2-microglobulin levels (> 3× normal) as individual risk factors (p<0.01). The sensitivity of β2-microglobulin levels was 78% and a positive predictive value of 80%. Multivariate regression analysis on steroid-resistant nephrotic syndrome as a group did not confer a higher risk; however, for children with focal segmental glomerulosclerosis, the likelihood of steroid unresponsiveness was significantly higher for the same parameters. Conclusion: The addition of biomarker measurement and known clinical risk factors helped predict steroid-resistant focal segmental glomerulosclerosis. However, further studies are warranted before these results can be generalized.

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“…6 Local data from Pakistan showed FSGS to be the commonest histopathological pattern among children having SRNS. 7 FSGS is considered to have variable outcomes as half of the cases are observed to reach end stage kidney disease (ESKD) when they reach 15 years of age whereas multi-centric data from developing countries noted FSGS to be the commonest form of GS contributing to 10.2% pediatric cases that ended up as ESKD. 8,9 Natural history of FSGS has been elaborated but its management is still a topic of concern.…”

Section: Introductionmentioning

confidence: 99%

Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience

et al. 2021

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Objectives: To find out frequency, clinicopathological features, response of treatment and outcome among children with primary focal segmental glomerulosclerosis (FSGS). Methods: This retrospective, non-interventional medical charts review study was conducted from a period of January 2011 to January 2020 at Pediatric Department of Nishtar Medical University Hospital, Multan, Pakistan. During the nine years study period, children of both genders, aged less than 16 years, with renal biopsies proven FSGS were included. Patient’s demographic along with clinical and laboratory data, urine dipstick for proteinuria, renal functions, 24 hours urinary protein and ultrasonography findings of kidneys, ureters and bladder (KUB) were noted from case records. Response rates of various treatment options and their outcome like remission, partial remission, no remission with stable kidney disease & no remission with progression of kidney disease were noted. Results: During the study duration, out of 307 renal biopsies performed in glomerulonephritis cases, 124 (40.4%) had primary FSGS. In 124 primary FSGS cases, mean age was 8.83±3.05 years while most of the children, 70 (56.5%) were above 10 years of age. Majority of the cases, 64 (51.6%) were male. Mean follow up duration was noted to be 28.35+18.47 months. Most of the cases, 68 (54.8%) were found to have complete remission, 22 (17.7%) partial remission while 11 (8.9%) progressed to ESKD. Conclusions: Among children, frequency of primary FSGS was high at our setting. Most of the cases achieved sustained remission rates with the help of immunosuppressive drugs. Cyclosporine and tacrolimus were found to be the most effective drugs. doi: https://doi.org/10.12669/pjms.37.2.3535 How to cite this:Safdar RS, Mehar MF, Khan AA, Buzdar N. Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3535 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Clinicopathological profile of pediatric renal biopsies at a tertiary care hospital, Pakistan

Cited by 7 publications

References 0 publications

Morphological Audit of glomerular diseases in a tertiary care Hospital.

Morphological Audit of glomerular diseases in a tertiary care Hospital.

Can Steroid Response in Idiopathic Childhood Nephrotic Syndrome be Predicted? A Single Center Quasi-Experimental Study

Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience

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