Deepa Gandra 1 , Vikas Chennamaneni 2
ABSTRACT: CONTEXT: Etiology of nephrotic syndrome (NS) in adults varies depending on the geographical location and is poorly studied in the Indian subcontinent. AIMS: To study the clinical features, biochemical profile and histopathological pattern of various types of glomerulonephritis in adult patients with nephrotic syndrome. METHODS AND MATERIAL: Patients (≥15 years old) with nephrotic syndrome presenting to our center and undergoing a kidney biopsy from May 2009 to August 2011 were included for this study. All biopsies were subjected to light microscopy.The histopathological spectrum was analyzed according to the various clinical parameters. STATISTICAL ANALYSIS USED: Analysis was performed using SPSS software version 19.Measures obtained included percentages,medians,correlation coefficients and chi square tests. RESULTS: A total of 50 kidney biopsies were included in analysis. Twenty six(52%) patients were male and twenty four(48%) patients were female. The average age at presentation was 15-24 years. Among the patients, 22(44%) were diagnosed with primary glomerular diseases (PGD) and 4(8%) with secondary glomerular diseases (SGD). The most common histological lesions was membranous nephropathy(24.4%) followed by minimal change disease (MCD) (17%) and membranous nephropathy (MN) (17%). The most common form of SGD was lupus nephritis (LN) (10%). Membranous nephropathy and focal segmental glomerulosclerosis were the commonest lesions in males.Among females,membranous nephropathy was the commonest. 31(62%) patients were in the age group of 15-34 yrs, 17(34%) were in the age group 34- 54yrs and only 2(4%) were aged above 55yrs. Among the patients, 6(12%) had serum creatinine ≥1.5 mg/dL and 12(24%) had either macroscopic or microscopic hematuria. CONCLUSIONS: Membranous nephropathy is still the commonest type of nephrotic syndrome in adults followed closely by focal segmental glomerulosclerosis and minimal change disease as per this study.
