Histomorphologic Pattern of Renal Disease in Patients with Acute Nephritic syndrome: A Single Centre South Indian Study
Keywords:
Acute nephritic syndrome, glomerulonephritis, post infectious glomerulonephritis, renal biopsy.
Abstract
Background: The frequency and distribution of primary and secondary glomerular disorders presenting as acute nephritic syndrome (ANS) varies according to the geographic and racial characteristics, renal biopsy practices and patient selection criteria. The present study was carried out to determine the histomorphologic patterns of lesions in renal biopsies from patients presenting with ANS.Methods: The study was conducted on patients presenting with ANS, in a tertiary care hospital in South India, during the period between 2008 and 2015. The renal biopsies performed were studied by light and immunofluorescence microscopy.Results: A total of 112 patients of ANS, with a male: female ratio of 1: 1.5 and mean age of 32.9 ±16.85 years, were included. Primary glomerular disease (PGD) was present in 77.7% and secondary glomerular disease (SGD) in 22.3% of the cases. The commonest PGD presenting as ANS was postinfectious glomerulonephritis followed by crescentic glomerulonephritis. The commonest SGD causing ANS was lupus nephritis (LN).Conclusion: A range of PGD and SGD can present as ANS. Various studies, done in India and abroad, show variations in the frequency and distribution of PGD presenting as ANS. The distribution pattern of SGD presenting as ANS largely corresponds to the pattern described in other Indian studies with LN being the commonest.References
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2. Colvin RB editor. Introduction to Renal Pathology. In: Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.1-2.
3. Iseki K, Miyasato F, Uehara H, Tokuyama K, Toma S, Nishime K, et al. Outcome study of renal biopsy patients in Okinawa, Japan. Kidney International. 2004;66:914-9.
4. Rahaman MA, Kamal M, Rahman MS, Biswas MA, Sarker RA: Histomorphological Patterns of Glomerulonephritis in Patients Presenting with Acute Nephritic Syndrome Dinajpur Med Col J. 2012;5:26-33.
5. Das U, Dakshinamurthy KV, Prayaga A. Pattern of biopsy-proven renal disease in a single center of south India: 19 years experience . Indian J of Nephrol. 2011;21:250-7.
6. Emmett M, Fenves AZ, Schwartz JC. Approach to the patient with Kidney disease. In: Tall MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, editors. Brenner and Rector’s The Kidney, 9th ed. Philadelphia: Elsevier; 2012.p.844-67.
7. Satoskar AA, Nadasky T, Silva FG. Acute Postinfectious Glomerulonephritis and Glomerulonephritis caused by persistent Bacterial Infection. Chapter 10. In: Jennette JC, Olson JL, Silva FG, D’Agati VD, editors. Hepinstall’s Pathology of the Kidney, 7th ed.. Lippincott Williams & Wilkins, Philadelphia. 2015;1:367-436.
8. Jennette JC, Nickeleit V. Anti-Glomerular Basement Membrane Glomerulonephritis and Goodpasture Syndrome. Chapter 15. In: Jennette JC, Olson JL, Silva FG, D’Agati VD, editors. Hepinstall’s Pathology of the Kidney, 7th ed. Lippincott Williams & Wilkins, Philadelphia. 2015;1:657-84.
9. Jennette JC, Thomas DB. Pauci-immune and Antineutrophil Cytoplasmic Autoantibody Mediated Crescentic Glomerulonephritis and Vasculitis. Chapter 16. In: Jennette JC, Olson JL, Silva FG, D’Agati VD, editors. Hepinstall’s Pathology of the Kidney, 7th ed. Lippincott Williams & Wilkins, Philadelphia. 2015;1:685-713.
10. Colvin RB. Classification of Membranoproliferative Glomerulonephritis and Complement- related Diseases. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.64-73.
11. Cornell LD. IgA Nephropathy. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.142-155.
12. Chang A. Membranous Glomerulonephritis. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.46-55.
13. Farris AB. Focal Segmental Glomerulosclerosis Classification. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.14-17.
14. Meehan SM. Systemic Lupus Erythematosus. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.170-187.
15. Chang A. Henoch- Schonlein Purpura. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.156-63.
16. Kambham N. Haemolytic Uremic Syndrome, Infection related. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.70-73.
17. Farris AB. Hypertensive Renovascular Disease. In: Colvin RB editor. Diagnostic Pathology. Kidney Diseases. 1st ed. Canada: Amirys Publishing Inc; 2011.p.106-113.
18. The University of Tennessee Health Science Center Nephrology [Internet]. Tennessee. Renal syndromes leading to abnormal kidney function [updated 2014 March 14] Available from: https://www.uthsc.edu/nephrology/documents/renal-syndromes-guide.pdf
19. Floege J, Feehally J. Introduction to Glomerular disease: Clinical presentations. In: Johnson RJ, Freehally J, Floege J, editors. Comprehensive Clinical Nephrology. 5th ed. Philadelphia. Elsevier Inc; 2015.p.184-97.
20. Deshpande SA, Kale K, Moulick ND. Clinico-histopathological correlation of Nephritic Syndrome in adults in urban population. International J. of Healthcare and Biomedical Research. 2015;3:34-45.
21. Polito MG, Ribeiro de Moura LA, Kirsztajn GM. An overview on frequency of renal biopsy diagnosis in Brazil: clinical and pathological patterns based on 9617 native kidney biopsies. Nephrol Dial Transplant. 2010;25:490–6
22. Naumovic R, Pavlovic S, Stojkovic D, Basta-Jovanovic G, Nesic V. Renal biopsy registry from a single centre in Serbia: 20 years of experience. Nephrol Dial Transplant. 2009;24:877–85.
23. D'Agati VD. Renal Disease in Systemic Lupus Erythematosus, Mixed Connective Tissue Disease, Sjogren's Syndrome, and Rheumatoid Arthritis, Chapter 12. In: Jennette JC, Olson JL, Schwartz MM, Silva FG, editors. Hepinstall’s Pathology of the Kidney, 6th ed. Lippincott Williams & Wilkins, Philadelphia. 2007;1:518-612.
24. Pesce F, Schena FP. World distribution of glomerular diseases: the role of renal biopsy registries. Nephrol Dial Transplant. 2013;28:334-6.
Published
2016-11-06
Section
Original Article
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