Spectrum of Biopsy Proven Renal Disease - Referral Hospital Experience in a Developing Nations: Analysis Based on 624 Renal Biopsies

Background The spectrum of biopsy-proven renal disease (BPRD) varies according to the race, age, sex, demography, geographic area, infectious diseases, socioeconomic condition, from centre to centre, indication of renal biopsy and gives information that is useful for clinical practice. A nation-wide renal registry is not yet organized in India and there is a scarcity of information on the pattern of biopsy proven renal disease. Objectives To study the epidemiology of biopsy proven renal disease (BPRD) and to look for any changing trends in renal disease in comparison to other studies. Material and Methods A retrospective analysis of the histopathological reports of all native kidney biopsies performed from 2008 2014 (n=624) at a tertiary care hospital in South India. All renal biopsies were studied by light and immunofluorescence microscopy and also special stains wherever required. Results A total of 624 cases were analyzed in the study. Patients age ranges from 4 months to 68 years. The male female ratio was 1.071. The most common clinical indication for renal biopsy was NS (39 %). Out of all, primary glomerular disease (PGD) was the most common BPRD, accounting for 60.25 % of the total cases. Minimal change disease 20.47 ( %) was the commonest PGD followed by focal segmental glomerulosclerosis (18.35 %) and membranous nephropathy (16.22 %). Tubulointerstitial nephritis (TIN) (16.66 % total BPRD) is the second most common BPRD. Acute TIN accounts for 56.73 %of the total TIN. Secondary glomerular disease (SGD) is third most common. SGD accounts for 13.78 % of total BPRD. Lupus nephritis (62.79 % of total SGD) was the commonest SGD followed by HUS/TTP (12.76 %total SGD). In our study DN (10.46 % total SGD) is third most common SGD. Chronic renal parenchymal changes (5.12 % total BPRD) and vascular disease (4.17 % total BPRD) were less common. Conclusion This study provides epidemiological biopsy data in renal diseases in South India and provides information about some important trends in changing prevalence of renal disease pattern.