A retrospective study of 252 renal biopsies

Abstract

To describe the following in patients undergoing renal biopsies in Sri Lankan hospitals; The common indications, associated clinical and laboratory parameters, prevalence of diseases with secondary renal involvement in this population the pattern of biopsy conclusion. Design: A retrospective descriptive study of 252 renal biopsies carried out from January 1998 to September 2000. Method: Data was collected from biopsy request forms and pathologists reports using a pretested data sheet. Results conclusions: The most frequent indications for biopsy were. nephrotic syndrome 133 (54.3%), asymptomatic proteinuria 31 (12.7%). acute nephritis 27 (11%). In the nephrotic category serum creatinine levels were elevated in 55 (45%) patients. The commonest histological diagnoses were. minimal change disease in 58 (43.6%), focal segmental glomerulosclerosis (FSGS) in 20 (15%). In patients presenting with asymptomatic proteinuria 20 (64.5%) had diastolic blood pressure above 90mmHg. 18 (66.6%) serum creatinine levels were elevated. 2 patients (7.4%) with asymptomatic proteinuria had SLE with renal involvement. Acute diffuse proliferative glomerulonephritis was seen in 12 (44.4%), diffuse proliferative glomerulonephritis ,mesangiocapillary glomerulonephritis in 2 (11%) patients each. More males i.e. 14 (77.7%) had presented with rapidly progressive glomerulonephritis; the pathology of the majority of them was crescentic glomerulonephritis 13 (72.3%). In the asymptomatic heamaturia group, 24 hour urinary protein excretion was over 1500 mg/day in 4 (44%) patients. Biopsy was normal In 4 and showea IgA nephropathy in another 4 (36.4%). Mean age for chronic renal failure was 31 years (SD=11.68). The commonest biopsy conclusions were chronic sclerosing lomerulonephritis in 5 (62.5%) patients and chonic tubulointerstitial nephritis in 3 (37.5%) patients. In patients with acute renal failure, 5 (83%) had identifiable secondary causes, snake bite 2 (40%) was the commonest. Commonest pathology was acute tubulointerstitial nephritis seen in 3 (50%) patients. More females, 4 (66.7%), presented with vasculitic syndrome. All had a secondary cause, SLE HSP accounted for a patient each (16.67%). Biopsy showed minimal change disease in 2 patients (33.3%).