scholarly journals Spectrum of Renal Parenchymal Diseases: An Eleven Year Retrospective Review of Renal Biopsy Data from a Tertiary Care Hospital in Pakistan

2017 ◽  
Vol 23 (1) ◽  
Author(s):  
Naila Asif ◽  
Muhammad Nadeem Ahsan ◽  
Shafqat Waqar Khanzada
Keyword(s):  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Membranous Nephropathy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Glomerular Disease ◽  
Care Hospital ◽  
Glomerular Lesion ◽  
Segmental Glomerulosclerosis ◽  
Renal Biopsies

<p><strong>Objective:</strong><strong>  </strong>To report our experience with renal biopsy and histopathological pattern of renal disease in a tertiary care hospital in Pakistan over 11 years period.</p><p><strong>Methods:</strong><strong>  </strong>All the kidney biopsies performed in our unit from Jan 2001 to Dec 2011 were retrospectively reviewed. We recorded the following data for each patient: name, age, sex, indications for renal biopsy, histopathological diagnosis and lab investigations such as Serum Creatinine, 24 hour urinary protein, urine microscopy, virology (Hbs Ag, Anti HCV) and serology (antids DNA, ANA, C3, C4, C-ANCA and p-ANCA) when indicated. Histopathological examination included Light Microscopy (LM) and Immunofluorescence Microscopy (IF). For LM, six sections were taken and stained with Haemotoxilin and Eosin, and special stains included Periodic acid-Schiff (PAS), Trichome and Grocott’ Smethanamine Silver Stain (GMS). IF study was done using polyclonal antisera against human IgG, IgM, IgA, C3 and Cq. The renal biopsies were performed by a trained Nephrologist.</p><p><strong>Results:</strong><strong>  </strong>A total of 329 consecutive percutaneous renal biopsies of native kidneys were reviewed. A total of thirteen specimens were unsatisfactory. Nineteen cases had incomplete data, therefore were excluded. There were 159 males (53.3%) and 138 females (46.46%). Age distribution showed a total no. of 34 (11.44%) of paediatric cases, 238 (80.13%) adult cases and 25 (10.5 %) elderly cases. The most common clinical indication for renal biopsy was unexplained renal failure (n = 116 39%) followed by nephrotic syndrome (n = 83 27.9%). Of the total biopsies included 248 (82.82%) had glomerular disease and 49 (16.49%) had non glomerular disease. The most frequently found primary glomerular lesion was membranous nephropathy (n = 51 17%) followed by focal segmental glomerulosclerosis (n = 26 8.7%). Amongst the non-glomerular lesions, CIN (chronic interstitial nephritis) was the most frequently found lesion (n = 24 8.08%).</p><p><strong>Conclusion:  </strong>Membranous Nephropathy followed by Focal Segmental Glomerulosclerosis were the most frequently found renal lesion.</p>

scholarly journals Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Rabia Saleem Safdar ◽  
M Faisal Mehar ◽  
Afsheen Asghar ◽  
Nusrat Buzdar
Keyword(s):  
Kidney Disease ◽  
Focal Segmental Glomerulosclerosis ◽  
Partial Remission ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Paediatric Population ◽  
Care Hospital ◽  
Segmental Glomerulosclerosis ◽  
Hospital Experience ◽  
Renal Biopsies

Objectives: To find out frequency, clinicopathological features, response of treatment and outcome among children with primary focal segmental glomerulosclerosis (FSGS). Methods: This retrospective, non-interventional medical charts review study was conducted from a period of January 2011 to January 2020 at Pediatric Department of Nishtar Medical University Hospital, Multan, Pakistan. During the nine years study period, children of both genders, aged less than 16 years, with renal biopsies proven FSGS were included. Patient’s demographic along with clinical and laboratory data, urine dipstick for proteinuria, renal functions, 24 hours urinary protein and ultrasonography findings of kidneys, ureters and bladder (KUB) were noted from case records. Response rates of various treatment options and their outcome like remission, partial remission, no remission with stable kidney disease & no remission with progression of kidney disease were noted. Results: During the study duration, out of 307 renal biopsies performed in glomerulonephritis cases, 124 (40.4%) had primary FSGS. In 124 primary FSGS cases, mean age was 8.83±3.05 years while most of the children, 70 (56.5%) were above 10 years of age. Majority of the cases, 64 (51.6%) were male. Mean follow up duration was noted to be 28.35+18.47 months. Most of the cases, 68 (54.8%) were found to have complete remission, 22 (17.7%) partial remission while 11 (8.9%) progressed to ESKD. Conclusions: Among children, frequency of primary FSGS was high at our setting. Most of the cases achieved sustained remission rates with the help of immunosuppressive drugs. Cyclosporine and tacrolimus were found to be the most effective drugs. doi: https://doi.org/10.12669/pjms.37.2.3535 How to cite this:Safdar RS, Mehar MF, Khan AA, Buzdar N. Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3535 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Ultrasound-guided percutaneous renal biopsy at a university hospital: retrospective analysis of success and complication rates

2021 ◽  
Vol 54 (5) ◽  
pp. 311-317
Author(s):  
Orlando Vieira Gomes ◽  
Bianca Alencar Dias de Almeida ◽  
Leonardo Fernandes e Santana ◽  
Mateus de Sousa Rodrigues ◽  
Guilherme Bruno Pires Marques Locio ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Retrospective Analysis ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
University Hospital ◽  
Complication Rates ◽  
Care Hospital ◽  
Success Rates ◽  
Ultrasound Guided ◽  
Second Procedure

Abstract Objective: To evaluate the success and complication rates of ultrasound-guided renal biopsy at a tertiary care hospital. Materials and Methods: This was a retrospective analysis of 97 ultrasound-guided renal biopsies, all performed by the same radiologist, between 1 March, 2017 and 31 October, 2019. Results: Of the 97 biopsies evaluated, 87 had a definitive pathological diagnosis. In five cases (5.4%), the biopsy results were inconclusive and a second procedure was required. In seven procedures (7.6%), there were complications, all of which were properly resolved. Conclusion: Ultrasound-guided renal biopsy has proven to be a safe, effective method for the diagnosis of nephropathies, with high success rates.

scholarly journals The Association between Glomerular Diameter and Secondary Focal Segmental Glomerulosclerosis in Chronic Kidney Disease

2021 ◽  
pp. 1-8
Author(s):  
Ryo Zamami ◽  
Kentaro Kohagura ◽  
Kojiro Kinjyo ◽  
Takuto Nakamura ◽  
Takanori Kinjo ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Characteristic Curve ◽  
Area Under The Curve ◽  
Glomerular Hypertrophy ◽  
Glomerular Lesion ◽  
Segmental Glomerulosclerosis ◽  
Glomerular Size

<b><i>Introduction:</i></b> When nephron loss occurs, the glomerular filtration rate (GFR) is suggested to be maintained by glomerular hypertrophy, but excessive hypertrophy can rather lead to the formation of focal segmental glomerulosclerosis (FSGS), thereby causing progressive kidney damage. However, it is not clear how much glomerular hypertrophy leads to the formation of FSGS. We examined the association between glomerular diameter and FSGS lesions in chronic kidney disease (CKD) patients. <b><i>Methods:</i></b> We recruited 77 patients who underwent renal biopsy during 2016–2017; however, those identified with primary FSGS and glomerulonephritis with active glomerular lesion were excluded. We evaluated the maximal glomerular diameter (Max GD), an indicator of glomerular size, in each renal biopsy specimen and examined its association with FSGS lesion. <b><i>Results:</i></b> The median age, blood pressure, and estimated GFR of the patients were 53 years, 122/70 mm Hg, and 65 mL/min/1.73 m<sup>2</sup>, respectively. The optimal cutoff threshold of Max GD for predicting the presence of FSGS lesions, assessed by receiver operating characteristic curve analysis, was determined to be at 224 μm (area under the curve, 0.81; sensitivity, 81%; specificity, 72%). Multivariate logistic regression analyses demonstrated that Max GD ≥224 μm was significantly associated with the presence of FSGS lesions, independent of other confounding factors (odds ratio, 11.70; 95% confidence interval, 1.93–70.84). <b><i>Discussion/Conclusion:</i></b> Glomerular hypertrophy (Max GD ≥224 μm) has been associated with FSGS lesions in CKD patients and may reflect the limits of the compensatory process.

scholarly journals RENAL BIOPSY IN PAEDIATRIC POPULATION

1969 ◽  
Vol 3 (2) ◽  
pp. 314-317
Author(s):  
AHMAD ZEB KHAN ◽  
RIAZ GUL ◽  
AZIZ AHMAD
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
Focal Segmental Glomerulosclerosis ◽  
Minimal Change Disease ◽  
Paediatric Population ◽  
Minimal Change ◽  
Segmental Glomerulosclerosis ◽  
Renal Biopsies ◽  
A Prospective Study ◽  
Nephrotic Range Proteinuria

OBJECTIVE: To find out the pattern of glomerulopathies in paediatric population, undergoing renalbiopsy at Khyber Teaching Hospital, Peshawar.METHODS: This was a prospective study carried out at the department of Nephrology at Khyber TeachingHospital, Peshawar from June 2010 till June 2012. Ultrasound guided percutaneous renal biopsies werecarried out in patients with the finding of; 1 ) Nephrotic range proteinuria in children. 2) Non-Nephroticrange proteinuria with evidence of hypertension / haematuria / deranged renal function or active sedimentson urine microscopy. 3) Steroid resistant nephrotic syndrome in children (patients not responding to steroidin eight weeks time) and 4) Children with nephrotic syndrome who were not tolerant of steroid therapy orwere considered for immunosuppressive drugs.RESULT: A total of 155 renal biopsies were done. Out of these 90 were male patients and 65 were females.The most common histopathological lesion among children population was minimal change disease(42.66%) followed by focal segmental glomerulosclerosis (25.33%) and membranous GN (16.0%). Weobserved that nephrotic range proteinuria was most prevalent in minimal change disease and membranousGN followed by focal segmental glomerulosclerosis. While non-nephrotic range proteinuria was mostlyseen in patients with membranoprolifirative GN.CONCLUSION: In paediatric population, minimal change disease is the most common encounteredglomerulopathy, followed by focal segmental glomerulosclerosisand membranous GN.KEY WORDS: Nephrotic syndrome, Renal biopsy, Proteinuria, Glomerulopathy

P0841SPECTRUM OF RENAL DISORDERS AT A TERTIARY CARE HOSPITAL IN KARACHI, PAKISTAN: RESULTS FROM AN OUTPATIENTS DATABASE IN A DEVELOPING COUNTRY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Sonia Yaqub ◽  
Safia Awan
Keyword(s):  
Membranous Nephropathy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Renal Stones ◽  
University Hospital ◽  
Renal Diseases ◽  
Care Hospital ◽  
Renal Disorders ◽  
Common Diagnosis ◽  
One Year

Abstract Background and Aims The burden of renal diseases in developing countries is rising. However, little is known about the epidemiology and clinical pattern of various disorders in our part of the world. The objective of this study was to understand the burden of disease faced by nephrologists in a tertiary care setting. Method It was a prospective observational study of all presentations to nephrology clinics at Aga Khan University Hospital Karachi over a period of one year. Results A total of 1589 out-patients with renal diseases were seen during the study period. The mean age of the study participants were 49.9 years and 629 (53%) were male. 88.6% of patients belonged to Karachi and Hyderabad areas of Sind province. CKD was the most common diagnosis (93.5%). Diabetic kidney disease and hypertension and related disorders were causes of CKD in 29.5% and 29.1% cases respectively. In 13.1% patients, the etiology of CKD could not be determined. Among glomerulonephritis (6.67%), membranous nephropathy was the commonest disorder (32.1%) followed by FSGS (29.2%), Minimal change disease (15.1%) and IgA nephropathy (10.4%). SLE and lupus nephritis was seen in 48 patients (4.0%). Around 10% patients were suffering from various tubulointerstitial diseases (renal stones, UTIs, Acute and chronic tubulointerstitial nephritis). Conclusion It’s a first study of its kind reporting frequency of various renal disorders from an outpatient registry at a tertiary care hospital in Pakistan. Diabetes and hypertension account for almost 60% of cases with CKD. Membranous nephropathy is the commonest glomerular disease in an urban population cohort. We need more studies on spectrum of renal diseases for better planning and available resource management.

Sign in / Sign up

Export Citation Format

Share Document