The spectrum of glomerular diseases in a single center: A clinicopathological correlation

Abstract

We report the spectrum of biopsy-proven glomerular disease (GD) in a single center in Eastern India. Medical records of 666 patients with biopsy-proven GD over a period of 2 years from July 2010 to July 2012 were retrospectively analyzed. The clinical, laboratory, and histological data were recorded. All biopsy specimens were examined by the same pathologist with light and immunofluorescence microscopy. Electron microscopic analysis was performed only in selected cases. Histologic spectrum of various GDs was studied along with its correlation with the clinical and laboratory parameters. The clinical diagnosis was nephrotic syndrome (NS) in 410 (61.56%), rapidly progressive renal failure/glomerulonephritis in 130 (19.52%), subnephrotic proteinuria/asymtomatic urinary abnormalities in 52 (7.81%), acute kidney injury/acute nephritic syndrome in 40 (6.01%), and macroscopic hematuria in 4 (0.6%) patients. Male: Female ratio was 1.05; 27.92% (n = 186) were < 18 years, 68.47% (n = 456) were 18–59 years, and 3.6% (n = 24) were ≥ 60 years of age. The most common GD was minimal change disease (MCD) (20.12%, n = 134); others were focal segmental glomerulosclerosis (FSGS) (18.02%, n = 15.32%), lupus nephritis (LN) (15.32%, n = 102), membranous nephropathy (MN) (12.01%, n = 80), and IgA nephropathy (IgAN) (8.11%, n = 54). Primary GD was present in 79.13% (n = 527) and common histologies were MCD (25.42%), FSGS (22.58%), MN (14.42%), and IgAN (10.25%). Secondary GD was present in 20.87% (n = 139), with the most common being LN (73.38%, n = 102). Among the NS (n = 410), the most common GD was MCD (31.46%), followed by FSGS (25.6%), MN (15.58%), LN (7.8%), IgAN (6.09%), and membranoproliferative glomerulonephritis (4.88%). FSGS was the most common primary GD in adults, MCD in children, and MN in the elderly patients. The spectrum of GD varies according to the area of study and changes over time. A biopsy registry is needed for documenting this variation.

Spectrum of glomerular diseases - clinico-pathologic observations from a state run tertiary care centre

“…The most common indication for renal biopsy for GD was Nephrotic syndrome (44.38%) comparable to other studies where contribution of NS to total biopsies ranged from 34-60%. 3,11 Biopsies done for asymptomatic urinary abnormalities were the least common indication amongst the clinical syndromes in this study (1.17%), similar to many of the studies from the Indian subcontinent. This incidence is quite low compared to the data from biopsy registries of some centres in Europe and the far-east.…”

“…12 Primary GDs were found to predominate as compared to secondary GDs, as mentioned in several other studies. 3,11 FSGS was the most common primary GD in the study group(17.08% of total biopsy proven GDs;29.73% of all primary GDs). Most of the studies from Indian subcontinent and neighbouring countries show similar rising trends in the incidence of FSGS.…”

“…Most of the studies from Indian subcontinent and neighbouring countries show similar rising trends in the incidence of FSGS. 3,11 The most common FSGS variant was NOS (76.49%) followed by collapsing in 7.8%,tip in 6.8%, cellular in 4.9% and perihilar in 3.92%. Similarly, Golay et al reported 119 FSGS patients.…”

Histopathological Pattern of Glomerulonephritis: Experience from BIRDEM General Hospital, Dhaka, Bangladesh

“…Primary glomerular disease (70%) is the most prominent renal disease in our study as well as in all recent studies.. 2,[15][16][17][18][19][20][21][22][23] A study from Jamaica showed SGN were more common probably due to their aggressive biopsy policy in patients with SLE. 10 Like other studies, 16 proliferative GN is more prevalent than nonproliferative GN in our study.…”

Prevalence of Specific Types of Kidney Disease in Patients Undergoing Kidney Biopsy: A Single Centre Experience

“…18 In our subcontinent, the most prevalent secondary glomerular disease in China and India is SLE. 19,20 Higher frequency of LN cases in our cohort of renal biopsy may mean aggressive nature of SLE dominant in our study population.…”