Clinicopathological profile and outcomes of pediatric glomerular diseases: A tertiary care experience
DOI:
https://doi.org/10.12669/pjms.42.9.13794Keywords:
Glomerular diseases, Indications, Renal, biopsy, HistologyAbstract
Background & Objective: Glomerular diseases in children are significant cause of renal morbidity and mortality, causing significant burden on health care system. Data regarding the outcomes of paediatric patients with glomerular diseseas in association with clinicopathological findings is critical to understand the management plan and prognosis. To determine clinical spectrum, histopathological findings and outcome of children with glomerular disease who underwent renal biopsy.
Methodology: Cross sectional retrospective study conducted at nephrology department of National institute of child health from January 2016 to December 2020. All children aged 1 to 18 years who underwent percutaneous renal biopsy were included. Data recorded from the files including demographics, clinical presentations, diagnosis, histopathological findings, post biopsy complications and their outcome at last follow-up were noted. Data were analyzed using SPSS version 23.
Results: Seventy children with mean age of 6.85 + 3.54 were included. Males were 56.9% and females were 43.1%. Most common presentation was edema 95.8% followed by oliguria 77.7 % and then hypertension 44.4%. Most common indication for renal biopsy was steroid resistant Nephrotic syndrome (SRNS) 56.9% followed by rapid progressive glomerulonephritis (RPGN) syndrome 16.7%. In histopathological findings focal segmental glomerulonephritis (FSGS) and Minimal change disease (MCD) were seen in 33% and 26% respectively. Post biopsy complications were observed in 21 % that includes hematuria, local site infection, hematoma formation on ultrasound. On follow-up, majority (75.7%), had preserved renal functions. Only 5.6 % developed chronic kidney disease.
Conclusion:Common presentations were edema, oliguria and hypertension. SRNS and RPGN were common indications for kidney biopsy. FSGS and MCD were common histopathological findings. Outcome was normal kidney functions in majority and few developed chronic kidney disease.
