Histopathological spectrum of Adult Nephrotic Syndrome over 16 years at a Tertiary care center in Mumbai with Clinicopathological ,Electron microscopy and Immunoflurescence Correlation of Renal biopsies

  • Ganesh Ramdas Kshirsagar Department Of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital,Sion ,Mumbai 400022, Maharashtra,India.
  • Nitin Maheswar Gadgil Department Of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital,Sion ,Mumbai 400022, Maharashtra,India.
  • Sangeeta Ramulu Margam Department Of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital,Sion ,Mumbai 400022, Maharashtra,India.
  • Chetan Sudhakar Chaudhari Department Of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital,Sion ,Mumbai 400022, Maharashtra,India.
  • Prashant Vijay Kumavat Department Of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital,Sion ,Mumbai 400022, Maharashtra,India.
  • Sheela Jayawant Pagare Department Of Pathology, Lokmanya Tilak Municipal Medical College and General Hospital,Sion ,Mumbai 400022, Maharashtra,India.
Keywords: Nephrotic syndrome, renal biopsy, minimal change disease, membranoproliferative glomerulonephritis, focal segmental glomerulosclerosis, electron microscopy

Abstract

Background: The pattern of diseases causing adult nephrotic syndrome varies globally as well as in India. The aim of our study was to analyze the spectrum of patients with biopsy proven nephrotic syndrome in adults over 15 years, in respect with incidence , age distribution and correlate the clinicopathological features, electron microscopy and immunofluorescence.Methods: We have evaluated and analyzed retrospectively 263 renal biopsies of adult nephrotic syndrome over a consecutive period of 16 years (January 2000 to December 2015) in our tertiary care Hospital.Result: In our study of 235 (89.35%) adequate renal biopsy cases overall male predominance was seen (M: F ratio 1.7:1) with maximum males noted in diabetic nephropathy (M: F ratio 4:1) while SLE was seen exclusively in female (M: F ratio 0:6). Minimal change disease (26.38%), followed by MPGN (16.17%) and FSGS (15.74%) were the common histopathological lesions. In 15-45 years age majority of 78.72% cases were observed with prominently histomorphological pattern as MCD( 25.10%),followed by FSGS ( 13.61%) & MPGN (13.19%). In 45-85 years age , 21.28% cases  majority were of membranous glomerulonephritis (5.10%) and diabetic nephropathy (4.25%). Primary glomerular diseases accounted for 78.3% cases commonest was MCD (26.38%) and secondary glomerular diseases in 21.7% of cases, most common being amyloidosis (7.23%)  Light microscopy, immunopathology findings correlated with electron microscopy findings in 79 cases (91.86%) out of 86 cases. Sample error was main reason of non correlation of EM & LM diagnosis ,especially in FSGS.Conclusion: This data analysis is essential to study the prevalence of biopsy proven renal diseases and its variation and distribution as per age .Which can improve the understanding of utility of renal biopsy for future research of renal parenchymal diseases in adults. 

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Published
2017-12-19
Issue
Vol 4 No 6 (2017)
Section
Original Article

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