scholarly journals Pattern of glomerular disease in a tertiary care hospital in Nepal: A Shree Birendra Hospital experience

2012 ◽  
Vol 7 (4) ◽  
pp. 48-52
Author(s):  
A Sharma ◽  
RK Deo ◽  
RR Shahi
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Glomerular Disease ◽  
Renal Diseases ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Glomerular Diseases ◽  
Patient Profile ◽  
Nephritic Syndrome ◽  
Number Of Patients

The incidence of renal diseases varies greatly in various parts of the world. Percutaneous renal biopsy is an important procedure for many patients with renal disease. This hospital based retrospective study evaluated the pattern of various glomerular diseases in Shree Birendra hospital. Hospital records were searched for all the patients undergoing renal biopsy for all indication and patient profile and histopathological examination record were obtained. All the patients undergoing renal biopsy for any cause from January 2007 to December 2010 were included in the study. A total of 46 patients underwent renal biopsy in the study period. The number of patients in the various age groups were - <16 years – 5 patients, 16-50 years – 34 patients and > 50 years – 7 patients. The number of male and female patients was 34 and 12 respectively. Major indication for undergoing renal biopsy in this study was Nephrotic Syndrome (n=29, 63%), followed by RPGN (n=8, 17%), Persistent proteinuria (n=6, 13%) and Nephritic syndrome (n=3, 7%). The most common histopathological diagnosis in the study was Membranous nephropathy (n=10, 22%), followed by Focal Segmental Glomerulosclerosis (n=9, 20%), Membranoproliferative glomerulonephritis (n=9, 20%) and Minimal change disease (n=6, 13%). USG guided renal biopsy is safe in adults and is a very useful tool for the diagnosis of renal disease. The pattern of glomerular disease varies in different settings. There is a need for further evaluation of glomerular disease with larger sample size to determine the pattern of glomerular disease in Nepal. Journal of College of Medical Sciences-Nepal,2011,Vol-7,No-4, 48-52 DOI: http://dx.doi.org/10.3126/jcmsn.v7i4.6742

scholarly journals The Spectrum of Biopsy-Proved Kidney Disease: A Retrospective Single Center Study in Erbil-Iraq

2019 ◽  
Vol 10 (2) ◽  
pp. 46-51
Author(s):  
Ahmed Al-Imam ◽  
Mudhafar Abdullah Ali ◽  
Safa Ezzaddin Al-Mukhtar
Keyword(s):  
Renal Failure ◽  
Renal Biopsy ◽  
Immunofluorescence Microscopy ◽  
Histopathological Examination ◽  
Glomerular Disease ◽  
Clinical Indication ◽  
Renal Diseases ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
Management Protocol

BACKGROUND Renal biopsy is crucial to determine the pattern of the different types of renal diseases. It represents the gold standard of diagnostics for renal pathologies, including glomerular diseases, and it has an important value for the prognosis, monitoring disease progression, and planning the management protocol. AIMS AND OBJECTIVE To report the frequency of different pathological lesions affecting the kidney in patients who were admitted to our medical centre. MATERIALS AND METHODS This is a retrospective study of all patients with renal diseases who underwent percutaneous renal biopsy at the Erbil Kidney Centre for eight years  (1st of January 2010  to 31st of December 2017). A total of 893 cases were biopsied and subsequently studied via histopathological examination and immunofluorescence microscopy. The study is ethically permitted by the Kurdistan Board for Medical Specialization. RESULTS The average age of the patients was 30.9 years. The most common clinical indication for biopsy included nephrotic syndrome (46.47%), acute renal failure (19.04%), chronic renal failure (15.34%), nephritic syndrome (7.39%), proteinuria alone (7.28%), and hematuria alone (4.48%). In patients with a primary glomerular disease, focal segmental glomerulosclerosis and minimal change disease were the most frequent (27.44% and 16.01%) in the younger patients (18.61±13.47 years), while membranous glomerulonephritis was more common in older patients (38.94±13.69 years). Patients with a secondary glomerular disease were mainly diagnosed with lupus nephritis, amyloidosis, and diabetic nephropathy. CONCLUSION The epitome of our study signifies that the spectrum of glomerular diseases varies based on age, sex, ethnicity, and geographical distribution. The implementation of renal biopsy proved to be a cornerstone in reaching the correct diagnosis. Future studies should implement the use of electron microscopy in conjunction with classical techniques of histopathology and immunofluorescence microscopy to diagnose equivocal cases of interest.

scholarly journals Renal Biopsy in 2015 - From Epidemiology to Evidence-Based Indications

2016 ◽  
Vol 43 (1) ◽  
pp. 1-19 ◽  
Author(s):  
Marco Fiorentino ◽  
Davide Bolignano ◽  
Vladimir Tesar ◽  
Anna Pisano ◽  
Wim Van Biesen ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Renal Biopsy ◽  
Systemic Disease ◽  
Renal Involvement ◽  
Renal Diseases ◽  
Evidence Based ◽  
Source Population ◽  
Glomerular Diseases ◽  
Number Of Patients ◽  
Renal Histology

Background: Although the number of patients reaching end-stage kidney disease without a biopsy-proven diagnosis is increasing, the utility of renal biopsy is still an object of debate. We analyzed epidemiological data and the main indications for renal biopsy with a systematic, evidence-based review at current literature. Summary: There is a high discrepancy observed in biopsy rates and in the epidemiology of glomerular diseases worldwide, related to the different time frame of the analyzed reports, lack of data collection, the different reference source population and the heterogeneity of indications. The evidence-based analysis of indications showed that renal biopsy should be crucial in adults with nephrotic syndrome or urinary abnormalities as coexistent hematuria and proteinuria and in corticosteroid resistant-children with severe proteinuria. The knowledge of renal histology can change the clinical management in patients with acute kidney injury significantly, after the exclusion of pre-renal or obstructive causes of kidney damage. Scarce evidence indicates that renal biopsy can be useful in patients with advanced chronic kidney disease and its use should always be considered after weighing the benefits and potential risks. Renal biopsy should be crucial in patients with renal involvement due to systemic disease. In patients with diabetes with atypical features, renal biopsy may be fundamental to diagnose an unexpected parenchymal disease mislabeled as diabetic nephropathy. Finally, in elderly patients, the indications and the risks are not different from those in the general population. Key Message: Renal biopsy still remains a concrete approach for managing a substantial percentage of renal diseases.

scholarly journals Histomorphological Spectrum of Glomerulopathies: A Review

2021 ◽  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Public Health Problem ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
Positive Impression ◽  
Stage Renal Disease ◽  
End Stage ◽  
Disease Analysis ◽  
Morphological Patterns

Renal disease and dysfunction is a worldwide public health problem. The underlying pathology in most renal disease is glomerulopathy, largely referred to as glomerulonephritis. It can be primary or secondary to other diseases. A range of morphological patterns was observed in this condition, each with different etiopathogenetic mechanisms, diverse clinical presentation, disease progression and therapeutic responses. We searched the literature using Hinari, PubMed and Google Scholar, for appropriate studies. This review was conducted by employing specified methods and structures using histopathology-confirmed data during the year 2011 to 2020. Thirty-five studies consisting of 13,423 reported renal biopsy cases were covered in this review. The most common indication of the renal biopsy was nephrotic syndrome followed by proteinuria and nephritic syndrome. Focal segmental glomerulosclerosis, minimal change disease, and mesangio-capillary glomerulonephritis among others, were the most frequently reported primary patterns of glomerulopathies. Glomerular diseases remain poorly characterized due to the scarcity of data on histo-morphological patterns of glomerulopathies. The development of registries regarding renal biopsy may offer a chance to characterize the pervasiveness and patterns of glomerulopathies and have a positive impression on chronic/end stage renal disease analysis and treatment since most glomerular diseases are complaisant to treatment.

PERCUTANEOUS RENAL BIOPSY IN CHILDREN

PEDIATRICS ◽  
1962 ◽  
Vol 30 (2) ◽  
pp. 287-296
Author(s):  
W. F. Dodge ◽  
C. W. Daeschner ◽  
J. C. Brennan ◽  
H. S. Rosenberg ◽  
L. B. Travis ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Clinical Importance ◽  
Renal Diseases ◽  
Renal Lesion ◽  
Bleeding Tendency ◽  
Percutaneous Renal Biopsy ◽  
The One ◽  
Selection Of

Since 1951, when the percutaneous renal biopsy was introduced as an adjunctive method for study of patients with renal disease, reports of some 4,000 kidney biopsies have appeared in the literature. Only about 250 of these, however, have been performed in children. A biopsy specimen containing 5 to 10 glomeruli has been reported to be adequate for interpretation and to be representative of the total renal parenchyma in 84% of the cases with diffuse renal disease. Using a biopsy technique similar to that described by Kark, we have obtained an adequate specimen in 92% of 205 kidney biopsies performed in 168 children with diffuse renal diseases. Seven deaths have been previously reported in the literature. The circumstances surrounding the death of these seven patients and of the one death that occurred in our series are described. Perirenal hematoma has had a reported incidence of 0.4%. It has been our experience, as well as that of the other investigators, that if blood boss is replaced, the patient has an otherwise uneventful course and the mass subsequently disappears. Gross hematuria has had a reported incidence of 5.2%. Microscopic hematuria, lasting for 6 to 12 hours after biopsy, has been found to be the rule rather than the exception. The complications which have occurred have been associated with bleeding, and therefore a careful history concerning bleeding tendency and a study of the clotting mechanism is essential if the risk of needle renal biopsy is to be minimized. In addition to a bleeding tendency or defect in clotting mechanism, most investigators are agreed that the presence of only one kidney or an uncooperative patient are absolute contraindications to renal biopsy. The renal biopsy is primarily, at present, an additional and most useful investigative tool in the elucidation of the pathogenesis, natural history (by serial studies) and effectiveness of specific therapy upon the various renal diseases. It is of practical clinical importance in the selection of those patients with the nephrotic syndrome in whom glucocorticoid therapy is likely to be beneficial or the patient with anuria whose renal lesion is probably reversible with time; and, as a guide to the effectiveness of therapy in patients with pyelonephritis or lupus nephritis. It is not a technique that can be recommended for general or casual use. A classification of the pathohistobogic findings of diffuse glomerulonephritis, patterned after Ellis, is presented and discussed. This classification will be used in the description and discussion of various renal diseases and systemic diseases with associated nephritis in the three subsequent papers.

Renal medicine

2021 ◽  
pp. 353-382
Author(s):  
Gopesh K. Modi ◽  
Vivekanand Jha
Keyword(s):  
Kidney Disease ◽  
Renal Disease ◽  
Rapidly Progressive Glomerulonephritis ◽  
Kidney Injury ◽  
Renal Stones ◽  
Renal Diseases ◽  
Acute Glomerulonephritis ◽  
Glomerular Diseases ◽  
Stage Renal Disease ◽  
End Stage

Assessing renal function, Urinalysis, Proteinuria, Hematuria, Chyluria, Imaging in renal disease, Kidney biopsy, Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), Diabetic Nephropathy, End Stage Renal Disease and Dialysis, Kidney Transplantation, Glomerular diseases, Acute glomerulonephritis, Urinary schistosomiasis (bilharzia), Infections and Kidney Disease, Rapidly Progressive glomerulonephritis, Tubulointerstitial Disease, Urinary Tract Infection, Vesico-ureteric reflux, Renal Stones, Renal Disease in Pregnancy, Renal Artery Stenosis, Renal Mass, Inherited Renal Diseases

scholarly journals P0114BENEFITS AND CHALLENGES OF A RENAL BIOPSY REGISTRY AND NETWORK - FCGG EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Wim Laurens ◽  
Johan De Meester ◽  
Ben Sprangers ◽  
Steven Van Laecke ◽  
Dendooven Amélie ◽  
...  
Keyword(s):  
Renal Disease ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Clinical Care ◽  
Adult Population ◽  
Age Groups ◽  
Time Frame ◽  
Renal Pathology ◽  
Renal Diseases ◽  
Renal Biopsies

Abstract Background and Aims End December 2016, a renal biopsy network in the Flemish region (Belgium) was founded as a collaboration between the renal pathologists and nephrologists. This FCGG network introduced a uniform renal biopsy request form, a well-structured report form of the renal pathology examination and a comprehensive list of renal pathology diagnoses. Method Following informed consent [99.5%] and in compliance with GDPR, the registration of the renal biopsies consists of basic categorical renal data, structured renal pathology information and the final clinical renal disease. Results In 2017 and 2018, 1385 renal biopsies were registered – 10.5 per million inhabitants per year; in addition, 28 patients had a repeat biopsy in the same time frame (2%). Of the pediatric patients ( age &lt; 18 years; N=92; 6.6%), 23 had IgA nephropathy, 20 a minimal change disease and 15 another type of glomerulonephritis. The biopsy was reported as normal or non-diagnostic in 15 patients (16%) – the majority was clinically considered as glomerulonephritis. The spectrum of the adult population was quite similar across gender and age groups: 56% glomerulonephritis [= IgA nephropathy [19%] + FSGS [8%] + pauci-immune glomerulonephritis [7%] + other GN [22%] ), 10% tubulo-interstitial nephritis, 7% acute tubular necrosis [ATN], 7% diabetes mellitus, and 7% nephroangiosclerosis. Exceptions are pauci-immune glomerulonephritis as the most important renal disease in women aged 65 years and older, and lupus nephritis as the second most important glomerulonephritis in women aged 18-44 years. Only a small percentage of adult renal biopsies yielded no result (7%), clinically interpreted as glomerulonephritis in 50% of the cases. Conclusion The FCGG network has provided a more intense collaboration between renal pathologists and nephrologists mainly by standardizing the renal biopsy reading and reporting across all centers. More precise estimates of the prevalent renal diseases were provided for the first time; however, in order to get full information, renal diseases diagnosed by other techniques ( serology, genetic analysis ) should also be collected in the future. Efforts will be done to coordinate the clinical care of renal diseases, particularly the more rare renal diseases, and to offer access to new therapeutic molecules or new schemes, through this super-regional network.

scholarly journals Edema in Renal Diseases – Current View on Pathogenesis

2016 ◽  
Vol 2 (1) ◽  
pp. pocj.5000204
Author(s):  
Irina Bobkova ◽  
Natalia Chebotareva ◽  
Lydiya Kozlovskaya ◽  
Evgenij Shilov
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Disease ◽  
Diuretic Therapy ◽  
Alternative Methods ◽  
Renal Diseases ◽  
Current View ◽  
Factors Affecting ◽  
Nephritic Syndrome ◽  
Effective Doses ◽  
Old Men

Edema is a common complication of numerous renal disease. In the recent past several aspects of the pathophysiology of this condition have been elucidated. We herein present a case of nephrotic syndrome in a 30 year-old men. The discussion revolves around the following key questions on fluid accumulation in renal disease: 1. What is edema? What diseases can cause edema? 2. What are the mechanisms of edema in nephrotic syndrome? 2a. The “underfill” theory 2b. The “overfill” theory 2c. Tubulointerstitial inflammation 2d. Vascular permeability 3. What are the mechanisms of edema in nephritic syndrome? 4. How can the volume status be assessed in patients with nephrotic syndrome? 5. What are therapeutic strategies for edema management? 6. What are the factors affecting response to diuretics? 7. How can we overcome the diuretics resistance? 7a. Effective doses of loop diuretics 7b. Combined diuretic therapy 7c. Intravenous administration of diuretics 7d. Albumin infusions 7e. Alternative methods of edema management 8. Conclusion.

scholarly journals Horseshoe kidney with PLA2R-positive membranous nephropathy

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuai-Shuai Shi ◽  
Xian-Zu Yang ◽  
Xiao-Ye Zhang ◽  
Hui-Dan Guo ◽  
Wen-Feng Wang ◽  
...  
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
Membranous Nephropathy ◽  
Horseshoe Kidney ◽  
Glomerular Disease ◽  
Urinary Stones ◽  
Abdominal Ultrasonography ◽  
Glomerular Diseases ◽  
Structural Abnormalities ◽  
Diagnosis Rate

Abstract Background Horseshoe kidney (HSK) is a common congenital defect of the urinary system. The most common complications are urinary tract infection, urinary stones, and hydronephrosis. HSK can be combined with glomerular diseases, but the diagnosis rate of renal biopsy is low due to structural abnormalities. There are only a few reports on HSK with glomerular disease. Here, we have reported a case of PLA2R-positive membranous nephropathy occurring in a patient with HSK. Case presentation After admission to the hospital due to oedema of both the lower extremities, the patient was diagnosed with nephrotic syndrome due to abnormal 24-h urine protein (7540 mg) and blood albumin (25 g/L) levels. Abdominal ultrasonography revealed HSK. The patient’s brother had a history of end-stage renal disease due to nephrotic syndrome. Therefore, the patient was diagnosed with PLA2R-positive stage II membranous nephropathy through renal biopsy under abdominal ultrasonography guidance. He was administered adequate prednisone and cyclophosphamide, and after 6 months of treatment, urinary protein excretion levels significantly decreased. Conclusion The risk and difficulty of renal biopsy in patients with HSK are increased due to structural abnormalities; however, renal biopsy can be accomplished through precise positioning with abdominal ultrasonography. In the literature, 20 cases of HSK with glomerular disease have been reported thus far. Because of the small number of cases, estimating the incidence rate of glomerular diseases in HSK is impossible, and the correlation between HSK and renal pathology cannot be stated. Further studies should be conducted and cases should be accumulated to elucidate this phenomenon.

scholarly journals A Pattern of Glomerular Diseases in Egyptian Children: A Single-center Experience

2021 ◽  
Vol 9 (B) ◽  
pp. 1305-1312
Author(s):  
Hoda Atef Abdelsattar Ibrahim ◽  
Aya Amin ◽  
Ahmed Zeid ◽  
Samar Sabry ◽  
Hesham Safouh
Keyword(s):  
Nephrotic Syndrome ◽  
Iga Nephropathy ◽  
Glomerular Disease ◽  
Diffuse Mesangial Sclerosis ◽  
Gross Hematuria ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
Study Results ◽  
Egyptian Children ◽  
Membranous Gn

BACKGROUND: Findings indicative of the glomerular disease are proteinuria, hematuria, nephrotic syndrome (NS), hypertension, and renal insufficiency. These presentations can be used to define different clinical patterns that resemble different underlying etiologies. METHODS: This study is a cross-sectional study enrolled in Children Hospital Cairo University. The study participants were recruited on two stages, retrospective and prospective stages. In the retrospective stage, all eligible patients across 5 years (between 2011 and 2015) with any glomerular disease were included in the study. In addition, prospectively, the new cases a long 6 months (from February 2016 till July 2016) with glomerular diseases were included in the study. RESULTS: A total of 594 cases with different glomerular diseases were identified. Cases were two groups: The retrospective group that involved 543 cases and the prospective group that included 51 cases. In the retrospective part of the study, the most common presentations were NS (68%), nephritis (16.4%), gross hematuria (10.5%), and nephrotic/nephritic syndrome (3.5%). The most common biopsies in the retrospective study were NS: MCNS (27.3%), NS: focal segmental glomerulosclerosis (FSGS) (23.4%), NS: Mesangioproliferative GN (9.4%), NS: Membranous GN (2.3%), Crescentric GN (3.9%), Membranous GN (0.8%), MPGN (0.8%), congenital nephrotic syndrome (CNS):Diffuse Mesangial Sclerosis (3.9%), CNS: Finnish type (2.3%), Alport (4.7%), IgA nephropathy (3.9%), IgM nephropathy (1.6%), lupus nephritis (LN) (3.1%), Thin basement membrane disease (3.1%), and others (9.4%) In the prospective study, the most common presentations were NS (76.5%), nephritis (11.8%), nephrotic/nephritic syndrome (7.8%), and gross hematuria (3.9%). The biopsies results were mainly NS: FSGS (33.3%) and NS: MCNS (33.3%). Other biopsies results in the prospective part were NS: Mesangioproliferative GN (16.7%), LN (8.3%), and IgA nephropathy (8.3%). CONCLUSION: The most common glomerular disease in childhood is NS. The most common pathology of glomerular diseases is minimal change NS.

P0501THE EPIDEMIOLOGICAL FEATURES OF PIRMARY GLOMERULAR DISEASES IN TURKEY: THE MULTICENTER STUDY OF TURKISH SOCIETY OF NEPHROLOGY GLOMERULAR DISEASES (TSN-GOLD) WORKING GROUP

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Aydin Turkmen ◽  
Abdullah Sumnu ◽  
Egemen Cebeci ◽  
Halil Yazici ◽  
Necmi Eren ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Membranous Nephropathy ◽  
Working Group ◽  
Glomerular Diseases ◽  
Nephritic Syndrome ◽  
The Mean ◽  
Primary Glomerular Diseases ◽  
Turkish Society

Abstract Background and Aims The largest data on the epidemiology of primary glomerular diseases (PGD) are obtained from the databases of countries or centers. Here, we presented the extended results of the Primary Glomerular Diseases Study of the Turkish Society of Nephrology Glomerular Diseases (TSN-GOLD)Working Group. Method The data of patients who underwent renal biopsy and diagnosed as primary glomerular disease were recorded in the database prepared for the study. Between May 2009 and May 2019, a total of 4399 patients from 47 centers were evaluated. Basal data of 3875 patients were analyzed after exclusion of those lacking light microscopy and immunofluorescence findings. Results The mean age was 41.5 ± 14.9 years. Of the patients, 1690 were female (43.6%) and 2180 (56.3%) were male. Nephrotic syndrome was the most common biopsy indication (51.7%). This was followed by asymptomatic urinary abnormalities (18.3%) and nephritic syndrome (17.8%). The most common PGH was IgA nephropathy (25.7%), followed by membranous nephropathy (25.6%) and FSGS (21.9%). The mean total number of glomeruli per biopsy was 17 ± 10. Mean baseline systolic blood pressure was 130 ± 20 mmHg and diastolic blood pressure was 81 ± 12 mmHg. Median proteinuria was 3300 (IQR: 1467-6307) mg / day, mean serum creatinine, estimated GFR and albumin values were 1.4 ± 1.5 mg / dl, 80.7 ± 39.1 ml / min and 3.2 ± 0.9 g / dl, respectively. Conclusion In Turkey, the incidence of IgA nephropathy patients have become more common than membranous nephropathy among PGD patients diagnosed with renal biopsy.

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