A Two Year Observation on Trend of Primary Glomerulonephritis in A Tertiary Care Hospital of Bangladesh (original) (raw)
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BIRDEM Medical Journal, 2017
Background: Glomerulonephritis (GN) remains the most probable underlying cause of end stage renal disease of uncertain aetiology in many developing countries including Bangladesh. The pattern of glomerular disease varies widely from country to country. In Bangladesh, the incidence and histological pattern of GN is inadequately described. We performed a study, aiming to determine the pattern of GN in a diabetic hospital of our country. Methods: It was a cross-sectional hospital based prospective study conducted at BIRDEM General Hospital starting from July 2013 to December 2014. It included all patients with suspected GN who underwent native kidney biopsy. Results: Total 57 biopsies were performed and four cases other than primary or secondary GN (renal cortical necrosis 1, tubulointertsitial nephritis 2,chronic GN 1) were excluded i.e total number of PGN was 37 and secondary GN was 16. number of patients with were 53. M:F was 1.2:1.Mean age was 42.35±15(14-72) years. Thirty one (58.49%) of the study subjects had diabetes mellitus (DM). Mesangialproliferative GN (15/37,40.5%) and diabetic nephropathy (9/16,56%) were the commonest histopathological pattern found among primary and secondary GN respectively. Membranoproliferative GN (10/37,27%),was the second commonly observed pattern followed by focal segmental proliferative GN (8%), membranous nephropathy (8%), focal segmental glomerulosclerosis (5.4%) in primary GN and lupus nephritis (6/16,38%) and Wegeners granulomatosis (1/16) were other varieties in secondary group. Among 53 cases, 37 had proliferative variety. Nephrotic range proteinuria (41.5%) was the commonest indication of biopsy and 22% had post biopsy bleeding and 3.7% required blood transfusion. Conclusion: In conclusion, mesangial proliferative and membranoproliferative GN are the two common causes of primary GN. Diabetic nephropathy is the commonest cause of secondary GN. Nephrotic range proteinuria was the main indication of biopsy. Post biopsy complication was negligible. Creation of a national renal registry is essential for obtaining more specific epidemiological data.
Journal of Medical Science And clinical Research, 2018
Introduction: Glomerulonephritis is the term reserved for the variety of renal disease in which inflammation of the glomerulus, manifested by proliferation of cellular elements, is secondary to immunologic mechanism. Acute glomerulonephritis (AGN) is major cause of morbidity in developing countries. This study is an attempt to evaluate the clinical characteristics, complications and outcome of acute nephritic syndrome. Methods: A prospective study was conducted on all the cases found to have acute glomerulonephritis, and sample size constituted all children between 2 years to 14 years, hospitalized in pediatric department of MKCG Medical college from Feb. 2017 to Jan.2018 with acute glomerulonephritis. Results: Out of 50 patients studied 64% were male and 36% were female. The peak age group was 5 to 10 years. Pyoderma was the most common predisposing condition (64%). Latent period between infection and onset of disease was highest in 15-21 days (38%). 86% patients had low C3 at the time of diagnosis. Majority of patients were with low complement C3 level and positive ASO titre. 92% with AGN recovered completely. Conclusion: AGN is a significant renal problem in children and one of the common causes of hospital admissions. Early identification, monitoring and management is required to prevent morbidity and mortality.
Glomerulonephritis disease pattern at Saudi tertiary care center
Saudi medical journal, 2017
To assess changes in the pattern of glomerular diseases to help guide optimal allocation of resources, to focus future reasearch, and improve outcomes. Methods: A retrospective chart review was conducted on kidney biopsies taken between 2007 and 2016 at a single tertiary care center in Saudi Arabia (King Fahad Medical City, Riyadh) to evaluate the prevalence and pattern of glomerulonephritis (GN). Results: The most common primary GN in 102 biopsies from adult patients with a mean age of 28.9 ± 13.6 years and 40.2% female, was focal and segmental glomerulosclerosis (35.3%). Among 64 patients with systemic lupus erythematosus associated nephritis, of whom most (82.8%) were female, lupus nephritis (LN) 4 (46.9%), and (LN) 3 (32.8%) were the most common lupus nephritis classes. Conclusion: Establishing prospective GN registries from which robust diagnosis, treatment, and outcomes data can be acquired is warranted; however, registry development and maintenance are often precluded by reso...
2020
ABSTRACTBackgroundThe spectrum and outcomes of crescentic glomerulonephritis in South Asia is vastly different from that reported worldwide and there is a paucity of information.MethodsIt was an observational cohort study of renal biopsies done in the largest tertiary center in South India over a period of 10 years with ≥50% crescents on histology.ResultsA total of 8645 kidney biopsies were done at our center from January 2006 to December 2015, and 200 (2.31%) were crescentic glomerulonephritis. Patients were categorized into three etiological groups - anti-GBM (type I), immune complex (type II) and pauci-immune (type III). The most common was type II (96, 46.5%), followed by type III (73, 38%) and then type I (31, 15.5%). Female preponderance was seen across all three types. About half of all the three types presented with recent onset hypertension. Type II had the highest median proteinuria (4.2 (2.1-6) g/day, p=0.06) and the median eGFR was lowest in type I (5 (4-8) ml/min/1.73m2...
Study of the Clinical Profile of Rapidly Progressive Glomerulonephritis
https://www.ijrrjournal.com/IJRR\_Vol.7\_Issue.4\_April2020/Abstract\_IJRR0037.html, 2020
RPGN is a type of nephritic syndrome, accompanied by extensive glomerular crescent formation that, if untreated, progresses to end-stage renal disease over weeks to months. Our study aims to identify factors affecting the treatment outcome in RPGN. Materials and Methods: A hospital based cross sectional study conducted in the Department of Nephrology at Government Medical College, Jammu for a period of one year after obtaining ethical clearance. Adults with rapidly progressive glomerulonephritis on the basis of renal biopsy were included. Routine clinical, biochemical parameters and biopsy findings were analyzed. Primary outcome identified the remission of the patient with 24-hour urine protein <500 mg/day and serum creatinine <1.4 mg/dl. Quantitative variables were compared using Mann-Whitney Test and qualitative variables were correlated using Chi-Square test/Fisher's exact test. A p value of <0.05 was considered statistically significant. Results: In our study, about two-third of patients (63.64%) had showed no response. About one-fourth (25.45%) of patients showed partial remission and 10.91% had complete remission. Age, gender, duration of symptoms prior to diagnosis, oliguria, hematuria, hemoptysis, quantity of proteinuria were not correlated with the primary outcomes. Significant correlation was observed with variables like entry serum creatinine, entry eGFR and need of RRT on admission. More than half (90%) of our patients had secondary complications like anemia followed by infections (67%). Conclusion: RPGN is an important cause of renal failure. Most of the patients present late to hospital. Serum creatinine and requirement of dialysis at presentation are important predictors for outcome in RPGN. Thus, to improve outcome, an early referral to nephrologist for early diagnosis and treatment is stressed.
Hong Kong Journal of Nephrology, 2010
Published studies from different centers in Saudi Arabia have reported contradicting results regarding glomerular lesions. In this retrospective study, we report our experience in King Fahd Hospital of the University at Al-Khobar in the Eastern province, including a description of the morphologic and clinical characteristics of primary and secondary glomerular disease. The study included 233 renal biopsies obtained from patients presenting with glomerular manifestations over a period of 23 years , investigated by light microscopy, immunofluorescence (149 cases) and electron microscopy (34 cases). One hundred and eighty-seven cases (80.3%) were primary glomerulonephritides. Minimal change glomerulopathy was the most common type of primary glomerulonephritis found (29.4% of primary glomerulonephritides), followed by mesangioproliferative glomerulonephritis (19.8%), and focal/segmental glomerulosclerosis (15.5%). Membranoproliferative glomerulonephritis was found in 9.6% of cases, membranous glomerulopathy in 8.6%, IgA nephropathy in 6.4%, end-stage glomerulopathy in 5.9%, crescentic glomerulonephritis in 3.2%, and IgM nephropathy in 1.6%. Of the secondary glomerulonephritides (46 cases constituting 19.7% of the biopsies), lupus nephritis was the most frequently diagnosed disease (71.7% of secondary glomerulonephritides). Diabetic glomerulosclerosis was found in 10.9% of cases, amyloidosis in 6.5%, and Alport syndrome in 4.3%. Wegener's granulomatosis, Henoch-Schönlein purpura nephritis and hypertensive nephrosclerosis each represented 2.2% of cases (one case each). Other than a significantly higher incidence of minimal change glomerulopathy and lupus nephritis (p < 0.001) and a significantly lower prevalence of membranoproliferative glomerulonephritis (p = 0.029), our results are generally comparable to those reported by the Saudi registry for glomerulopathy and in some neighboring countries. Ageand sex-adjusted analyses revealed that minimal change glomerulopathy and lupus nephritis were also the most prevalent primary and secondary glomerulopathies in the pediatric age group (below 15 years) as well as in adults, females and males. [Hong Kong J Nephrol 2010;12(1):20-30]
The incidence of biopsy‐proven glomerulonephritis in Australia
Nephrology Dialysis Transplantation, 2001
Background. There is limited population-based epidemiological data on renal disease. An insight into the spectrum of clinically signi®cant glomerulonephritis can be obtained from renal biopsy diagnoses. This is a descriptive report of biopsy-proven glomerulonephritis within a de®ned population. Methods. A retrospective review of the pathology reports of all native renal biopsies performed in the Australian state of Victoria in 1995 and 1997 was undertaken. Trends in the average annual age-and sex-speci®c incidence rates for biopsy-proven glomerulonephritis were calculated. Comparisons were made with the incidence of end-stage renal disease due to glomerulonephritis con®rmed on renal biopsy.