Abstract

PATTERN OF GLOMERULAR DISEASES IN PATIENTS WITH SIGNIFICANT PROTEINURIA: A CLINICOPATHOLOGICAL STUDY FROM UPPER ASSAM

Author(s): Sawjib Borphukan1, Surajit Gogoi2, Dev Baruah3

BACKGROUND
The prevalence of biopsy proven glomerular diseases varies according to the geographic area, race, age, demography and indication of renal biopsy. This has been poorly studied in the North-Eastern part of India, especially from Assam, the largest state, population-wise.
METHODS
This is a retrospective and observational study of kidney biopsy records and relevant clinical data of mainly adult patients. Patients (≥ 16 years old) presenting with significant proteinuria (> 2 g/24 hours) who attended our Medical College from October 2012 to September 2015 were subjected to kidney biopsy provided they were able to afford the cost and willing for the same. All biopsies were subjected to light and immunofluorescence microscopy. The histopathological pattern was analysed according to various clinical parameters.
RESULTS
A total of 136 kidney biopsies were included for analysis. 72 cases (52.9%) were males and 64 (47.1%) were females. Mean age of the patients was 37 ± 15.7 years. Among the patients, 85.3% (n = 116) were diagnosed with primary glomerular disease (PGD) and 14.7% (n = 20) were diagnosed with secondary glomerular disease (SGD). The most common histopathological lesion was minimal change disease (MCD) (27.9%) followed by membranous glomerulonephritis or nephropathy (MGN) (24.3%). In the age group ≥ 40 years, MGN (34.5%) was the predominant histological lesion followed by MCD (20.7%). Lupus nephritis (LN) (11%) was the most common secondary glomerular pathology. 20 of our patients (14.70%) had creatinine levels more than 1.5 mg/dL.
CONCLUSION
In this study, MCD was the commonest lesion in our north-east adult population in a wide age range. However, MGN was predominant in the middle age and elderly patients. This is in contrast to the trend in the increasing incidence of FSGS found in other parts of the country and western population.

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