CLINICOPATHOLOGICAL PATTERN AND OUTCOME OF PATIENTS WITH GLOMERULONEPHRITIS: A SINGLE CENTRE STUDY AT BANGLADESH MEDICAL COLLEGE HOSPITAL.

Introduction:

Glomerulonephritis (GN) refers to a group of diseases with different subtypes. GN is the third most common cause of End-stage renal disease (ESRD), following DM and hypertension. The prevalence of glomerular diseases varies with race, age, geographical region, and etiological, cultural and economic differences. It is therefore important to recognize and study differences in these diseases in any geographical region. So this study was done aiming to obtain a recent and comprehensive insight into the pattern of glomerular disease in Bangladesh population.

Methods:

This cross sectional study was done at department of Nephrology, Bangladesh Medical College Hospital. Total 446, histologically adequate samples were included in this study. All patients undergone required investigations and Patients underwent renal biopsy if they had fulfilled indication. All renal biopsy samples were examined with light microscopy and DIF. All patients were on regular follow up  and outcomes were measured as any one of the following; (1) Normalization of renal function - Complete Recovery (2) Persistent renal dysfunction without dialysis dependency (3) Hemodialysis dependent.

Results:

Among 446 patients, 233 patients were male and 213 females (male: female: 1.03:1) with mean age 33.4 years (range 12-63). Total 334 (74.8%) patients were from low socieo-economic status. Total 33 patients had concomitant DM. Among clinical presentation 219 patients presented with nephrotic syndrome which was most common clinical feature 49% followed by nephrite-nephrotic syndrome 24%, nephritic syndrome 9% and isolated hematuria 3% (Table-1). Thityone patients  (7%) presented with RPGN like feature among them 19  patients required immediate hemodialysis before renal biopsy. Among all glomerulopathy primary GN were 401(90%) and secondary 29(6.5%)]. (Table-2).

Among all, Mesangioproliferative (122,27.3%) found to be most common histological pattern, followed by Diffuse Membranoproliferative glomerulonephritis (DMPGN), (104,23.3%), focal segmental glomerulosclerosis (FSGS) 11.8%, Membranous nephropathy (MN) 7.6%, IgA nephropathy 10.3%, Minimal change disease(MCD) 2.2%, IgM 2.4%, C3GN 1.5% and C1GN 0.8%. Total 26 patients found with crescentic glomerulonephritis among them 21 patients progressed to ESRD (Table-3).

Among patients with Mesangioproliferative GN, most common presentation was nephrito-nephrotic syndrome 66 (54.3%) and total 107 patients reached complete remission. Among secondary GN Total 27 (6%) patients were lupus nephritis (class III 6, class IV 14, class V 1, class VI 1) (Table -4).

Total 21 patients were female and 17 patients had associated systemic features (arthritis 10/22, oral ulcer 12/22, rash 14/22) and 7 patients had only renal involvement and 6 patients presented with RPGN like presentation and two required immediate hemodialysis.  We had total 33 diabetic patients, seven patient s histologically proven Diabetic Glomerulosclerosis , one patient presented with RPGN like presentation renal biopsy report revealed Pauci-immune GN and now on immunosuppressive management with stable renal function.

Conclusions:

In our study, we have shown the varied clinicopatho- logical manifestations of patients presented with clinical features suggestive of GN. Mesangioproliferative and Membranoproliferative glomerulonephritis are two common cause of primary GN and among secondary GN lupus nephritis was most common which is very similar other studies in our country.

I have no potential conflict of interest to disclose.

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