Spectrum of Glomerular Disease on Kidney Biopsy: An Observational Study

Abstract

Introduction: Glomerular diseases are the leading causes of chronic kidney disease and end-stage kidney disease worldwide. Their distribution varies across regions, and data from Nepal are limited. Kidney biopsy is essential for accurate diagnosis, prognosis, and definitive therapy. This study aims to establish the histopathological spectrum of glomerular diseases in patients undergoing native kidney biopsy at specialized transplant hospital of Nepal. Methods: A retrospective observational study was conducted among 351 patients who underwent renal biopsy at Shahid Dharmabhakta National Transplant Center between January 2016 and December 2019. Demographic, clinical, and laboratory data were compiled from hospital records. Biopsies were performed under ultrasound guidance and examined using light microscopy and immunofluorescence. Data was analyzed descriptively. Results: Out of 351 patients, the median age of patients was 36 years (IQR 27–48), and 192 (54.70%) were male. Kidney biopsies were performed for nephrotic syndrome in 86 (24.50%) patients, Nephritic Syndrome in 77 (21.94%). IgA Nephropathy was seen in 108 (31.67%) patients. Focal Segmental Glomerulosclerosis in 76 (22.28%) and Non-proliferative Glomerulopathy in 41 (12.02%). Among 35 (10%) of lupus nephritis cases, Class IV (42.85%) was prevalent. The Oxford classification of IgA nephropathy revealed Segmental glomerulosclerosis (S1) in 10 (96.30%) patients, Tubular atrophy/Interstitial fibrosis (T1) in 62 (57.41%). Conclusions: Primary glomerular disease is common in the biopsy group in Nepal, and histologic evaluation is crucial for guiding diagnosis, prognosis, and prompt treatment of glomerular disorders. The findings also show the value of kidney biopsy in clinical practice and provide significant input into the epidemiology of glomerular disorders in Nepal.