The Pattern of Glomerulonephritis in the North Indian Gangetic Plain- A 13-Year Epidemiological Study 855-858
Dr Rahul Mannan B-79, SF, Ranjit Avenue, Amritsar-143001 Punjab (India) Phone: 09781613285 E-mail: firstname.lastname@example.org Rahul Mannan,
Tejinder Singh Bhasin,
Pramela Anthony Singh,
Introduction: Epidemiologic studies, along with clinico-pathologic correlations, are important indicators which can be used for defining the burden of a particular disease and also to ascertain the trend of that entity, in order to monitor it according to the population which is at risk.
Methods: The present study was undertaken over a period of thirteen years and it comprised of 226 patients at a single tertiary care centre in the northern part of India, so as to take a glimpse at the pattern of the disease in an area which had poor human development indices in comparison to the rest of India. Four percutaneous core (specimen) biopsies were retrieved after the ultra-sonographic localization of the kidneys in each individual case and these were subjected to light microscopic studies. The patients complaints and the complications post procedures were noted.
Results: There were 139 (61.50%) males and 87 (38.49%) females, with a male to female ratio of 1.5:1. The post procedure complications which were recorded were local pain at the biopsy site in 3.8% patients, loin to groin pain in 1.9 % patients and gross/ microscopic haematuria in 0.9% patients. The indications which required the performance of the biopsies among the different age groups were nephrotic syndrome (121 patients; 53.53%), nephritic syndrome (66 patients; 29.20%), renal failure of unknown aetiology (29 patients; 12.83%) and asymptomatic haematuria (10 patients; 4.42%). Of all the glomerulopathies, membranous glomerulonephritis (MGN) was the commonest morphological pattern (13.27%) which was noted, followed by end stage renal disease (ESRD)-12.83% and mesangioproliferative (MeGN)-8.84% and membranoproliferative glomerulonephritis (MPGN)-7.96% respectively.
Conclusions: The significant point which was noted in the present study was that the second commonest lesion which was seen on the biopsy specimen was that of ESRD (12.83%). In contrast to the findings of our study, ESRD was found to be not prevalent to such a degree in other studies which were done at other various geographical regions of India. Although ESRD was the second most common lesion which was found in the present study, a relatively high incidence in this area provided an insight into the challenges which were faced by the clinical nephrologists in the diagnosis and management of glomerular diseases in resource challenged countries.