Histopathological Spectrum of Renal Lesions in Adults with Proteinuria

Histopathological Spectrum of Renal Lesions in Adults with Proteinuria

Authors

  • Dr. Pavneet Kaur Selhi
  • Dr. Nisha Sharma
  • Dr. Harpreet Kaur
  • Dr. Vineeta Malhotra

DOI:

https://doi.org/10.70284/njirm.v5i5.809

Keywords:

Renal Biopsy, Proteinuria, Immunoflourescence

Abstract

Background and Objectives: Proteinuria of more than 2.0 g in 24 hours is indicative of renal disease and a value of more than 3.5 g is a component of Nephrotic syndrome. The pathology resulting in proteinuria can be glomerular, tubular and others. Renal biopsy is gold standard in evaluation and management of patients with proteinuria especially Nephrotic syndrome. Methods: A retrospective analysis of all renal biopsies from adult patients with significant proteinuria over a period of 4 years was performed to study the pattern of renal pathology. The morphological findings were correlated with Clinical findings, laboratory findings &Immunofluorescence profile as per availability. Results: It was observed that clinical diagnosis matched the final pathological diagnosis in 79 (58.09%) cases. Further, Light Microscopy findings corresponded with Immunofluorescence in 142 out of 158 cases, while the diagnosis was changed in 16 (10.13%) cases after IF. Conclusions: The results thus indicate that renal biopsy along with IF plays an important role in diagnosis of cases with significant proteinuria a fact highlighted by low concordance % between the clinical and the pathological diagnosis. An accurate diagnosis is not only essential to initiate appropriate therapy but also in prognostication of renal lesions. [Selhi P NJIRM 2014; 5(5):90-95]

References

1. Gimenez LF, Micali S, Chen RN et al. Laparoscopic renal biopsy. Kidney Int 1998; 54:525-9
2. Korbet SM. Percutaneous renal biopsy. SeminNephrol 2002; 22(3): 254-67
3. Fuller CE, Threattle GA, Henry JB. Basic examination of urine. In: Henry JB ed. Clinical Diagnosis and Management by Laboratory Methods. 20 Ed. Pennsylvania: Saunders 2001; 367-402
4. Stone RA. Office evaluation of the patient with proteinuria. Postgrad Med 1989; 86(5):241-4
5. Brady H, O’Meara Y, Brenner B. Glomerular Diseases. In: Kasper D, Braunwald E, Fauci A , Hauser S, Longo D, Jameson J. eds. Harrison’s Principles of internal medicine. Vol II, 16th edition. McGraw Hill. 2005; 1674-84
6. Rivera F, Gomez JML, Garcia RP. Clinicopathological correlations of renal biopsy in Spain. Kidney Int 2004; 66:898-904
7. Choi IJ, Jeong HJ, Hans DS et al. An analysis of 2361 cases of renal biopsy in Korea. Yonsei Med J 1991; 32(1):9-15
8. Narsimhan B, Chacko B, John GT et al. Characterization of kidney lesions in Indian adults: towards a renal biopsy registry. J Nephrol 2006; 19(2):205-10
9. Mitwalli AH, Al-Wakeel JS, Al-Mohaya SS et al. Pattern of glomerular disease in Saudi Arabia. Am J Kidney Dis 1996; 27(6): 797-802
10. Balakrishnan N, John GT, KorulaA et al. Spectrum of biopsy proven renal disease and changing trends at a tropical tertiary care centre1990 – 2001. Indian J Nephrol 2003;13:29-35
11. Schena FP and the Italian Group of Renal Immunopathology. Survey of the Italian Registry of Renal Biopsies. Frequency of the renal diseases for 7 consecutive years. Nephrol Dial Transplant 1997; 12:418–426
12. Rychlik I, Jancova E, Tesar V et al. The Czech registry of renal biopsies: occurrence of renal diseases in the year 1994-2000. Nephrol Dial Transplant 2004; 19(2): 3040-9
13. Richards NT, Darby S, Howie AJ et al. Knowledge of renal histology alters patient management in over 40% of cases. Nephrol Dial Transplant 1994; 9:1255-9
14. Al-Khader A, Al Sulaiman M, DharJM.Renal histology in Saudi population with overt nephrotic syndrome. Ann Saudi Med 1990; 5:581
15. Huraib SO, Abu-Aisha H, Mitwalli A et al. The spectrum of renal disease found by kidney biopsies at King Khalid University Hospital. Saudi Kidney Dis Transplant Bull 1990; 1:15-9
16. Chen H, Tang Z, Zeng C et al. Pathological demography of native patients in a nephrology center in China. Chin Med J 2003; 116:1377:81
17. Briganti EM, Dowling J, Finlay M, et al. The incidence of biopsy-proven glomerulonephritis in Australia. Nephrol Dial Transplant 2001; 16:1364-7
18. Turner MW, Hutchinson TA, Barre PE, Prichard S, Jothy S. A prospective study on the impact of renal biopsy in clinical management. ClinNephrol 1986; 26(5):217-21
19. Cohen AH, Nast CC, Adler SG et al.Clinical utility of kidney biopsies in the diagnosis and management of renal disease. Am J Nephrol 1989; 9:309-15
20. Pfister M, Jakob S, Frey FJ et al. Judgement analysis in clinical nephrology. Am J Kidney Dis 1999; 34(3):569-75
21. Date A, Pant M. How useful is immunoflorescence in tropical renal pathology? Trans R Soc Trop Med Hyg 1990; 84:599-601.
22. Abuelo JG. Proteinuria: diagnostic principles and procedures. Ann Intern Med 1983; 98:186-91

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Published

2018-01-05

How to Cite

Selhi, D. P. K., Sharma, D. N., Kaur, D. H., & Malhotra, D. V. (2018). Histopathological Spectrum of Renal Lesions in Adults with Proteinuria: Histopathological Spectrum of Renal Lesions in Adults with Proteinuria. National Journal of Integrated Research in Medicine, 5(5), 91–96. https://doi.org/10.70284/njirm.v5i5.809

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Original Articles