Clinico-pathological study of glomerular diseases in patients with significant proteinuria in North India

• Published in: Saudi journal of kidney diseases and transplantation Vol. 25; no. 2; pp. 443 - 449
• Main Authors: Punia, R. P. S., Kaur, Ravinder, Mundi, Irneet, Sachdev, Atul, DCruz, Sanjay
• Format: Journal Article
• Language: English
• Published: Riyadh, Saudi Arabia Saudi Center for Organ Transplantation 01.03.2014; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer Medknow Publications
• Subjects: Adolescent; Adult; Aged; Biopsy; Child; Demographic aspects; Diagnosis; Disease Progression; Female; Fluorescent Antibody Technique; Glomerulonephritis; Glomerulonephritis, Membranous - pathology; Glomerulosclerosis, Focal Segmental - pathology; Humans; India; Kidney diseases; Kidney Glomerulus - pathology; Kidneys; Male; Middle Aged; Nephritis, Interstitial - pathology; Nephrosis, Lipoid - pathology; Nephrotic Syndrome - pathology; Polyarteritis Nodosa - pathology; Prospective Studies; Proteinuria; Proteinuria - etiology; Renal Insufficiency - pathology; Young Adult; الأمراض; البروتين البولي; التهاب كبيبات الكلى; الكلى; المرضى; علم الأمراض التشريحي; India
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.128617

Proteinuria is a common manifestation of renal disease. The present study was carried out to analyze the clinico-pathological correlation, assess the value of histopathology and immunofluorescence (IF) as well as note the spectrum of renal diseases in patients with significant proteinuria. Fifty consecutive patients having proteinuria >1 g / 24 h underwent ultrasoundguided percutaneous renal biopsy. Clinical information was correlated with the pathological findings and the results were analyzed. The patients were in the age range of 12–79 years. Males (60 %) outnumbered females (40 %) in all the disease categories except lupus nephritis and IgA nephropathy. The most common clinical presentation was the nephrotic syndrome, seen in 31 cases (62 %). Primary glomerular diseases (72 %) were more common than secondary glomerular diseases (24%) and tubulointerstitial diseases (4 %). Overall, the most common pathological diagnosis was focal and segmental glomerulosclerosis (FSGS) (20 %), followed by membranous glomerulonephritis (MGN) (18 %). In young patients (age < 20 years), minimal change disease (36.4 %) was the most common diagnosis while in adults it was MGN (23.5 %) and in elderly patients (age > 60 years) it was FSGS (60 %). IF modified the diagnosis in 12 % of the cases. The concordance between clinical diagnosis and pathological diagnosis was 66 %. The difference between clinical diagnosis and final diagnosis was statistically significant. Our study further reinforces the knowledge that renal biopsy helps in accurate diagnosis and, thus, helps in appropriate management of the patients. IF provides additional information that can make the morphologic diagnosis considerably more precise.