Glomerulonephritis Histopathological Pattern Change

Abstract

Background Glomerulonephritides (GN) are relatively rare kidney diseases with substantial morbidity and mortality. They are often difficult to treat, sometimes with no cure, and can lead to chronic kidney disease (CKD) and end stage kidney disease (ESKD). Kidney biopsy is the diagnostic procedure of choice with variable indications from center to center. It helps in identifying the exact specific diagnosis, assessing the level of disease activity and severity, and hence aids in proper therapy and helps predicting prognosis. There is a global change of pattern of glomerular disease over the last five decades. Methods Retrospective analysis of all kidney biopsies (545 cases) that were done in patients over 12 year-old over last six years in four major hospitals in Kuwait. The indications for kidney biopsy were categorized into six clinical syndromes: nephrotic syndrome, sub-nephrotic proteinuria, nephrotic syndrome plus acute kidney injury (AKI), sub-nephrotic proteinuria plus AKI, isolated hematuria, and Unexplained renal impairment. We calculated the incidence of each type of kidney disease and indication of biopsy. Results most common indication of kidney biopsy was sub-nephrotic proteinuria associated with AKI in 179 cases (32.8%). Primary Glomerulonephritis was the main diagnosis that was reported in 356 cases (65.3%). Immunoglobulin A Nephropathy (IgAN) was the commonest lesion in primary glomerulonephritis in 85 (23.9%) cases. Secondary Glomerulonephritis was diagnosed in 134 cases (24.6%), 56 (41.8%) of them were reported as lupus nephritis cases. In young adults (below 18 years of age) there were 31 cases reviews, 35.5% were found to have minimal change disease (MCD). Conclusion IgAN is the commonest glomerulonephritis in primary nephrotic syndromes in Kuwait over the past six years. Lupus nephritis is the leading secondary glomerulonephritis diagnosis.

Factors affecting the relationship between ionized and corrected calcium levels in peritoneal dialysis patients: a retrospective cross-sectional study

“…Fourth, we did not have the data of a high-or low-calcium dialysate, values of 1, 25-dihydroxy vitamin D and 25-hydroxyvitamin D, and the type of peritoneal transport. Finally, the findings of the present study cannot be reflected in other populations because the distribution of primary kidney disease and several environmental factors differ based on races or regions of the world [46].…”

Severity and clinical causes of chronic kidney disease among outpatients from selected hospitals in Nairobi County, Kenya

“…15,19 However, the findings were different from some other studies due to availability of aggressive treatment of glomerulonephritis (18.5%) and improved public health hygiene. 12,18 Hypertensive nephrosclerosis (14.9%) was ranked third as a cause of CKD and had a statistical significant association with severity for CKD (OR 1.95; 95% CI; 1.87, 3.11). but contrary to findings reported by other studies.…”

“…16,17 However, due to availability of aggressive treatment of glomerulonephritis and improved public health hygiene, the pattern has changed. 18 In Australia, CKD caused by genetic diseases, obstruction, infections, urological conditions and drugs accounted for 30% of CKD cases. 19 Polycystic kidney disease accounts for 7% to 15% of CKD patients.…”

Histomorphological Spectrum of Glomerulopathies: A Review

“…Nephrotic syndrome is a combination of clinical presentation and laboratory outcomes embracing non-selective proteinuria (3.5 g/24 h), low level of albumin in the blood, increased level of cholesterol, and generalized edema [14][15][16] . Nephrotic syndrome is the most frequent cause of glomerular damage.…”