Title: Spectrum of Nephrotic Syndrome in Adults: Clinicopathological Study in a tertiary health care
Authors: Dr Shwetha Prasad B.S, Dr Sunil R, Dr Varun Manjunath, Dr Priyanka Venkatesh, Dr Shathak S Baikady, Dr Vikyath Sathish
DOI: https://dx.doi.org/10.18535/jmscr/v7i1.168
Abstract
Background: Nephrotic syndrome is one of the most common, yet, perplexing disease encountered by a nephrologist. The Nephrotic syndrome is now defined in published literature as a pentad of proteinuria more than 3.5 g per 24 h, hypoalbuminemia, edema, hyperlipidemia, and lipiduria Diseases causing the Nephrotic syndrome are generally categorized into those that primarily involve the kidney and those in which kidney involvement is part of a systemic disorder. Limited data from the Indian subcontinent on adult NS also show FSGS as the most common etiology. We present the clinicopathological study on the spectrum of NS in adults presenting to our center.
Methods: It is a retrospective study conducted on 50 subject’s age more than 16 years who underwent renal biopsy in KIMS hospital, Bengaluru.
Results: A total of 50 patients were analysed in our study with the mean age of 41.07 years. 43 (86%) were diagnosed with primary glomerular disease and 7 (14 %) with secondary glomerular disease. Among the patients, focal segmental Glomerulosclerosis was the most common nephropathy seen i.e, in 15(30%) followed by in membranous and membranoproliferative glomerulonephritis in 8 (16%). Among the primary glomerular disease, the most common lesions were FSGS in 30%, membranoproliferative glomerulonephritis (MPGN) and membranous glomerulonephritis (MGN) in 16% each. 31(62%) of patients had deranged Renal function tests.
Conclusion: FSGS was the most common cause of nephrotic syndrome in adults.
Keywords: nephrotic syndrome, focal segmental glomerulosclerosis, renal biopsy
References
- Eddy AE, Symons JM. Nephrotic syndrome in childhood. Lancet. 2003;362: 629–639.
- Emmett M, Fenves AZ, Schwartz JC. Approach to the patient with kidney disease. In: Taal MW, Chertow GM, Marsden PA, Skorecki K, Yu ASL, Brenner BM, eds. Brenner & Rector’s the Kidney. 9th ed., Vol. 1. Philadelphia: Saunders; 2012:844–867
- 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(4):250–257.
- 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.
- Polito MG, de Moura LA, Kirsztajn GM. An overview on frequency of renal biopsy diagnosis in Brazil: Clinical and pathological patterns based on 9,617 native kidney biopsies. Nephrol Dial Transplant. 2010;25:490–496.
- Narasimhan B, Chacko B, John GT, Korula A, Kirubakaran MG, Jacob CK. Characterization of kidney lesions in Indian adults: Towards a renal biopsy registry. J Nephrol. 2006;19 (2):205–210.
- Balakrishnan N, John GT, Korula A. Spectrum of biopsy proven renal disease and changing trends at a tropical tertiary care centre 1990–2001. Indian J Nephrol. 2003;13:29–35.
- Narasimhan B, Chacko B, John GT, Korula A, Kirubakaran MG, Jacob CK. Characterization of kidney lesions in Indian adults: Towards a renal biopsy registry. J Nephrol. 2006;19(2):205–210.