HISTOLOGICAL DIAGNOSIS OF KIDNEY DISEASE FROM RENAL BIOPSY REPORTS IN A TERTIARY HOSPITAL OF BANGLADESH -A 5-YEAR OBSERVATIONAL STUDY

Introduction:

To establish renal parenchymal kidney disease renal biopsies are the gold standard for diagnosis, staging, and prognosis. A variety of inflammatory and autoimmune processes lead to acute and progressive chronic kidney diseases. Clinical finding and laboratory tests cannot provide enough information in many cases as the pathology remains confined to renal parenchyma. A renal biopsy is indicated as knowledge of the histological diagnosis is essential for appropriate therapy.[1] Histological diagnosis obtained from a study conducted in Kidney Foundation Hospital and Research Institute Bangladesh in 2016 among 295 patients who underwent renal Biopsy found mesangial proliferative GN in 70 (24%), IgA nephropathy in 57 (19%), membranous nephropathy in 51 (17%), membrano-proliferative in 40 (14%), focal segmental glomerulosclerosis in 29 (10%), minimal change disease in 9 (3%), focal segmental nephritis in 28 (9%), and renal lupus in 11 (4%).This is a follow up study over 5 year period.

Methods:

An observational study over 5 years period (2019-2024) analyzing renal biopsy histological diagnosis of 956 patients in a tertiary center of Bangladesh. A standardized classification approach categorizes the diagnosis. The renal biopsy sample processed in a standard method with various stains for light microscopy and immunofluorescent was done on all samples.

Results:

956 patients had biopsy as it was indication for a variety of clinical presentations. Patients presented with Proteinuria, swelling with proteinuria, haematuria and proteinuria(Nephritic syndrome, nephrotic syndrome, known lupus nephritis, acute kidney injury, isolated haematuria and unexplained renal impairment indicating a renal biopsy.

Among 956 patient 484(51%) were male and 472(49%) were female. Among these 27 reports were missing. The average creatinine at the time of biopsy was 186 umol/l and eGFR was 64 mL/min/1.73m2.

The graph below shows the distribution of histopathological findings among 956 patients.

262 patients had more than one diagnosis on histopathology. The percentage of distribution is as follows.

FSGS (31%) was the most common presentation followed by IgA nephropathy (19.25%)then Infection associated GN(19%) , Lupus Nephritis(14%) , Minimal change disease(9.4%), Membranous nephropathy(9%), Diabetic nephropathy (5%),Tubulointerstitial nephritis(4.6%) and Interstitial nephritis(4.6%).The rest were less the 4%.

Conclusions:

There has been a change noted in histopathological distribution of diagnosis from renal Biopsy since 2016 with FSGS being the most common finding. This study shows the variety of clinical presentation that is associated with these renal biopsy diagnosis in this region.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.