The Histomorphological Spectrum of Renal Lesions in an Autopsy Study
Keywords:
Autopsy, Renal lesions, Histopathology, Acute tubular necrosis
Abstract
Background: Autopsy provides normal as well as diseased human tissue for morphologic studies, for establishment of cell and organ culture as well for xenotransplantation. It provides the opportunity to discover new diseases, to evaluate toxic effects of drugs and therapies. The kidneys are often affected by chronic inflammatory lesions, neoplasms , toxic effects of various drugs and metabolic disorders.Methods: This was a five year study from January 2011 to December 2015 in our department of pathology. The kidneys of medico legal autopsies performed during these years were subjected to our study. After excluding 30 cases of severely damaged tissue, 120 cases of well preserved renal medico legal autopsies were included in our study. The stained microscopic sections were examined by two histopathologists independently.Results: Seventy five of the 120 autopsies were males, while 45 were females. In 27 (22.5%) cases, the microscopic morphology was close to normal histology. Remaining 93(77.5%) cases had a nephropathological findings The percentage of non glomerular nephropathies (60.8%) was higher as compared to that of glomerular lesions (16%). 20 (16% ) cases exhibited glomerular alterations such focal global glomerular sclerosis, segmental glomerular sclerosis, nodular mesangial sclerosis, basement thickening and mesangial cellular proliferation. Tubular and interestium lesions were observed in 34.16% which included acute tubular necrosis, chronic pyelonephritis and tubercular pyelonephritis. Renal arteriosclerosis was observed in 25% cases. Renal cell carcinoma was incidentally detected in1.6%Conclusion:Our study provided satisfactory data in respect to morphological spectrum of various renal lesions in autopsy. DOI: 10.21276/APALM.1455References
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3.Imai E, Horio M, Watanabe T, Iseki K, Yamagata K, Hara S. Prevalence of chronic kidney disease in the Japanese general population.Clin Exp Nephrol 2009;13:621-630.
4. Hall YN, Hsu CY, Iribarren C Darbiman J, Mc Culloch CE, Go Alan S. The conundrum of increased burden of end stage renal disease in Asians. Kidney Int 2005;68:2310-2316.
5.Nagata M, Ninomiya T, Doi Y, Yonemolo K, Kubo M, Hata J. Trends in the prevalence of chronic kidney disease and its risk factors in a general population:the Hisayama Study. Nephrol Dial Transplant 2010;25:2557-2564.
6.Kurnatowaska I, Jedrzejka D Malyska A, Danilewicz MW, Danilewicz M, Nowicki M. Trends in the incidence of biopsy proven glomerular dieases in the adult population in central Poland in the years1990-2010.Kidney Blood Press Res 2012;35:254-258.
7.Zaza G, Bernich P, Lupo A. Triveneto Register of Renal Biopsies (TVRRB).Incidence of primary glomerulonephritis in a large North Eastern Italian area:a 13 year renal biopsy study.Nephrol Dial Transplant 2013;28:367-372.
8. Usta U, Tastekin E, Isler E, Kutlu AK, Puyan FO. Histopathological and immune alterations in autopsied kidneys.Saudi Med J 2014;35:1331-38.
9.Monga G, Mazzucco G, Boldorini R, Cristina S, Giacalone A, Fortunato M et al. Renal changes in patients with acquired immunodeficiency syndrome.a postmortem study on an unselected population in northwestern Italy.Mod Pathol 1997;10(3):159-67.
10.Martinez PM, Penta JM, Arnalich F, Garcia M, Adridanto O, Gonzalez J et al. Spectrum of renal pathology in HIV infection:descriptive of 85 autopsies and clinic-pathologic correlation.Rev ClinEsp 1996;196(9):557-83.
11. Hailemariam S, Walder M, Burger HR, et al.Renal pathology and premortem clinical presentation of Caucasian patients with AIDS: An autopsy study from the era prior to antiretroviral therapy.Swiss Med Wkly2001;131:412-17.
12.Bridgette J. Mc Namara, Boucar Diouf, et al. Renal pathology, glomerular number and volume in a West African urban community. Nephrol Dial Transplant2008;23:2576-2585.
13.Marcantoni C, Fogo AB:A perspective on arterionephrosclerosis: from pathology to pathogenesis.J Nephrol .2007;20:518.
14.Tracy RE. Recent declines of hypertensive renovasculopathies in New Orelans blacks.Am J Hypertens 2000;13:966-972.
15.Tracy RE, Rios-Dalenz JL. Rarity of hypertensive stigmata in aging renocortical arteries of Bolivians.Virchows Archiv 1994;424:307-314.
16.Tracy RE, Mulvad G, Pederson HS. Blood pressure in people in Greenland assed by renovasculopathies of hypertension at autopsy. Am J Hypertens 1996;9:560-565.
17.Rastogi P, Kanchan T, Menezes RG. Sudden unexpected deaths due to tuberculosis.An autopsy based study.Journal of Forsensic Medicine and Toxicology.2011;28:81-5.
18.Eastwood JB, Corbishley CM, Grange JM. Tuberculosis and the kidney.J AMSoc Nephrol.2000;12:1307-1314.
19. Kozlowska J, Okon K. Renal tumors in postmortem material.Pol J Pathol.2008;59:21-25.
20.Shah VB, Deokar MS. Spectrum of incidental renal masses detected at autopsy.Bombay Hosp J.2009;51:432-36
21. Patel S, Rajalakshmi BR, Manjunath GV. Histopathologic findings in autopsies with emphasis on interesting and incidental findings-A Pathologists Perspective.J of Clinicla and Diagnostic Research2016;10:8-12.
2. Schiffrin EL, Lipman ML, Mamm JF. Chronic kidney disease:effects on the cardiovascular system. Circulation 2007;116:85-97.
3.Imai E, Horio M, Watanabe T, Iseki K, Yamagata K, Hara S. Prevalence of chronic kidney disease in the Japanese general population.Clin Exp Nephrol 2009;13:621-630.
4. Hall YN, Hsu CY, Iribarren C Darbiman J, Mc Culloch CE, Go Alan S. The conundrum of increased burden of end stage renal disease in Asians. Kidney Int 2005;68:2310-2316.
5.Nagata M, Ninomiya T, Doi Y, Yonemolo K, Kubo M, Hata J. Trends in the prevalence of chronic kidney disease and its risk factors in a general population:the Hisayama Study. Nephrol Dial Transplant 2010;25:2557-2564.
6.Kurnatowaska I, Jedrzejka D Malyska A, Danilewicz MW, Danilewicz M, Nowicki M. Trends in the incidence of biopsy proven glomerular dieases in the adult population in central Poland in the years1990-2010.Kidney Blood Press Res 2012;35:254-258.
7.Zaza G, Bernich P, Lupo A. Triveneto Register of Renal Biopsies (TVRRB).Incidence of primary glomerulonephritis in a large North Eastern Italian area:a 13 year renal biopsy study.Nephrol Dial Transplant 2013;28:367-372.
8. Usta U, Tastekin E, Isler E, Kutlu AK, Puyan FO. Histopathological and immune alterations in autopsied kidneys.Saudi Med J 2014;35:1331-38.
9.Monga G, Mazzucco G, Boldorini R, Cristina S, Giacalone A, Fortunato M et al. Renal changes in patients with acquired immunodeficiency syndrome.a postmortem study on an unselected population in northwestern Italy.Mod Pathol 1997;10(3):159-67.
10.Martinez PM, Penta JM, Arnalich F, Garcia M, Adridanto O, Gonzalez J et al. Spectrum of renal pathology in HIV infection:descriptive of 85 autopsies and clinic-pathologic correlation.Rev ClinEsp 1996;196(9):557-83.
11. Hailemariam S, Walder M, Burger HR, et al.Renal pathology and premortem clinical presentation of Caucasian patients with AIDS: An autopsy study from the era prior to antiretroviral therapy.Swiss Med Wkly2001;131:412-17.
12.Bridgette J. Mc Namara, Boucar Diouf, et al. Renal pathology, glomerular number and volume in a West African urban community. Nephrol Dial Transplant2008;23:2576-2585.
13.Marcantoni C, Fogo AB:A perspective on arterionephrosclerosis: from pathology to pathogenesis.J Nephrol .2007;20:518.
14.Tracy RE. Recent declines of hypertensive renovasculopathies in New Orelans blacks.Am J Hypertens 2000;13:966-972.
15.Tracy RE, Rios-Dalenz JL. Rarity of hypertensive stigmata in aging renocortical arteries of Bolivians.Virchows Archiv 1994;424:307-314.
16.Tracy RE, Mulvad G, Pederson HS. Blood pressure in people in Greenland assed by renovasculopathies of hypertension at autopsy. Am J Hypertens 1996;9:560-565.
17.Rastogi P, Kanchan T, Menezes RG. Sudden unexpected deaths due to tuberculosis.An autopsy based study.Journal of Forsensic Medicine and Toxicology.2011;28:81-5.
18.Eastwood JB, Corbishley CM, Grange JM. Tuberculosis and the kidney.J AMSoc Nephrol.2000;12:1307-1314.
19. Kozlowska J, Okon K. Renal tumors in postmortem material.Pol J Pathol.2008;59:21-25.
20.Shah VB, Deokar MS. Spectrum of incidental renal masses detected at autopsy.Bombay Hosp J.2009;51:432-36
21. Patel S, Rajalakshmi BR, Manjunath GV. Histopathologic findings in autopsies with emphasis on interesting and incidental findings-A Pathologists Perspective.J of Clinicla and Diagnostic Research2016;10:8-12.
Published
2017-09-01
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