Nephrotic Syndrome: Clinico-Histopathological Spectrum in Tertiary Care Hospital of Rohelkhand of U.P (Bareilly)

Title: Nephrotic Syndrome: Clinico-Histopathological Spectrum in Tertiary Care Hospital of Rohelkhand of U.P (Bareilly)

Authors: Varshney Amit, Gupta Vijay, Sachan Amit, Singh Rohit, Nigam P

DOI: http://dx.doi.org/10.18535/jmscr/v3i8.01

DIDS : 08.2015-83974496

Abstract

References

Corresponding Author

Abstract

Nephrotic syndrome is a clinical entity characterized by massive proteinuria (primary albuminuria) leading to hypoproteinemia (hypoalbuminemia) leading to edema and fluids in serous cavities of the body. Hyperlipidemia, hypercholesterolemia and lipiduria are usually associated.

The present study was carried out to analyze the clinico-pathological correlation, asses the value of histopathology as well as to note the spectrum of renal disease in patients with significant proteinuria. Eighty four patients having evidences of nephrotic syndrome were included in this study and underwent ultrasound guided percutaneous renal biopsy. Clinical information was correlated with the pathological finding and results were analyzed. Their age ranged from 7 to 78 years (36.5± 16.7 years) with male to female ratio of 1.2:1. The common presentation of nephrotic syndrome was seen in 83 cases (98.8%) edema, with/without general anasarca, anemia (92.8%) , increase in body weight (80.9%) and ascites (73.8%) were common clinical manifestation. Primary glomerular disease (80.9%) were more common than secondary glomerular disease (19.1%). overall, the most common pathological diagnosis was MG/DLN(25%) and FSGS(20.2%) followed by MPGN(13.1%). The disease were more common in 21 to 40 yrs age group (30 cases o 35.7%) followed by 41 to 60 yrs (27 cases or 32.1%).

Our study reinforces the knowledge that renal biopsy helps in accurate diagnosis and thus help in appropriate management of patient. The MG/DLN and FSGS were common cause of nephrotic syndrome in the productive age group.

Keywords: nephrotic syndrome, focal segmental glomerulo sclerosis, membranous nephropathy, minimal change disease, renal biopsy.

References

1. Safaei.A,Maleknejad.S. Spectrum of childhood nephrotic syndrome in Iran: A single center study, indian journal of nephrology,2009,19:87-90.

2. Gupta. K, Distribution of pathologic findings in individuals with nephrotic proteinuria according to serum albumin. Nephrol Dial Transplant. 2008 May;23(5):1595-9.

3. Marcel Dekker . The Nephrotic Syndrome. New York: Dekker; 1988.

4. Haas M, Meehan SM, Karrison TG, et al. Changing etiologies of unexplained adult nephrotic syndrome: a comparison of renal biopsy findings from 1976–1979 and 1995–1997. Am J Kidney Dis 1997;30:621-631.

5. Burgstein JM. Nephrotic syndrome. In: Behrman RE, Kliegm/dlan RM, Jenson HB, editors. Nelson Textbook of pediatrics. 18th ed. Philadelphia: Saunders WB; 2008. p. 2430-42. Back to cited text no. 2

6. Falk JR, Jennette JC, Nachman PH. Primary glomerular disease. In: Brenner BM, Levine SA, editors. The Kidney. 7 th ed. Philadelphia: Saunders WB; 2004. p. 1295-307. Back to cited text no. 4

7. M. Rathi, R. L. Bhagat, and K. Joshi Changing histologic spectrum of adult nephrotic syndrome over five decades in north India: A single center experience ,indian journal of nephrology, 2014 Mar;24(2):86-91

8. Niaudet P. Steroid-sensitive idiopathic nephrotic syndrome. In: Avner ED, Harmon WE, Niaudet P, editors. Pediatric nephrology. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2004. p. 545-73.

9. Ozkaya N, Cakar N, Ekim M, Kara N, Akkok N, Yalcinkaya F. Primary nephrotic syndrome during childhood in Turkey. Pediatr Int 2004;46:436-8.

10. Kumar J, Culati S, Sharma P, Sharma RK. Histopathologial spectrum of childhood nephrotic syndrome in Indian children. Pediatr Nephrol 2003;18:660-75.

11. Cameron JS. The origins and development of the concept of a nephrotic syndrome. Am J Nephrol 2002;22:240-247

12. Floege J, Feehally J. Introduction to glomerular disease: Clinical presentations. In: Floege J, Johnson RJ, Feehally J. editors. Comprehensive Clinical Nephrology. 4 ^thed. St. Louis, Missouri: Saunders; 2010. p. 193-207.

13. Jennette JC, Falk RJ. Glomerular clinicopathologic syndromes. In: Greenberg A, Cheung AK, Coffman TM, Falk RJ, Jennette JC, editors. Primer on Kidney Diseases. 5 ^th ed. Philadelphia: Saunders; 2009. p. 148-59.

14. Smith HW. The Kidney: Structure and Function in Health and Disease. New York: Oxford University Press; 1964. p. 860.

15. Chugh KS, Sakhuja V. Renal diseases in Northern India. In: Kibukamusoke JW, editor. Tropical Nephrology. Canberra, Australia: City Forge Pty Ltd; 1984. pp. 428–40.

16. Chugh KS, Sakhuja V. Glomerular diseases in the tropics. Am J Nephrol. 1990;10:437–50.

17. Kitiyakara C, Kopp JB, Eggers P. Trends in the epidemiology of focal segm/dlental glomerulosclerosis. Semin Nephrol. 2003;23:172–82

18. Golay V, Trivedi M, Kurien AA, Sarkar D, Roychowdhary A, Pandey R. Spectrum of nephrotic syndrome in adults: Clinicopathological study from a single center in India. Ren Fail. 2013;35:487–91.

19. Agarwal SK, Dash SC. Spectrum of renal diseases in Indian adults. J Assoc Physicians India. 2000;48:594–600.

20. Aggarwal HK, Yashodara BM, Nand N, Sonia, Chakrabarti D, Bharti K. Spectrum of renal disorders in a tertiary care hospital in Haryana. J Assoc Physicians India. 2007;55:198–202.

21. Das U, Dakshinamurty KV, Prayaga A. Pattern of biopsy-proven renal disease in a single center of south India: 19 years experience. Indian J Nephrol. 2011;21:250–7

22. Kazi JI, Mubarak M, Ahmed E, Akhter F, Naqvi SA, Rizvi SA. Spectrum of glomerulonephritides in adults with nephrotic syndrome in Pakistan. Clin Exp Nephrol. 2009;13:38–43.

23. Garyal, Kafle RK. Hisopathological spectrum of glomerular disease in Nepal: A seven-year retrospective study. Nepal Med Coll J. 2008;10:126–8.

24. Chang JH, Kim DK, Kim HW, Park SY, Yoo TH, Kim BS, et al. Changing prevalence of glomerular diseases in Korean adults: A review of 20 years of experience. Nephrol Dial Transplant. 2009;24:2406–10.

25. Kitiyakara C, Eggers P, Kopp JB. Twenty-one-year trend in ESRD due to focal segm/dlental glomerulosclerosis in the United States. Am J Kidney Dis. 2004;44:815–25.

26. Gulati S, Sural S, Sharma RK, Gupta A, Gupta RK. Spectrum of adolescent-onset nephrotic syndrome in Indian children. Pediatr Nephrol. 2001;16:1045–8

Abstract

References

Corresponding Author

Call For Paper Volume 12 Issue 10 October 2024

JMSCR Menu

Impact Factor SJIF 2024: 7.892

Crossref - DOI

Editorial Policy

Frequency of Publication

Submission of Articles

Search