Spectrum of pathological lesions in acute renal failure

To determine the spectrum of pathological lesions in percutaneous renal biopsies of patients with acute renal failure (ARF) and to compare our findings with reported literature.

A single center based retrospective observational study.

The study was conducted in the Department of Histopathology, Sindh Institute of Urology and Transplantation, Karachi over a period of seven years (April 1995 to April 2002).

All the patients with ARF who presented to the emergency ward of SIUT between April 1995 and April, 2002 and in whom renal biopsy was performed, were included in this study. Patient's demographic and clinical data were collected from a review of patient's original surgical biopsy reports and case files. Pathological diagnosis was retrieved from a review of biopsy reports. Renal biopsies were received in 10% buffered formalin and processed for paraffin embedding and subsequent histopathological examination under the light microscope.

A total of 158 patients were studied. Of these 57 were males and 101 females. Mean age of the patients in this series was 30.7 years with a range of 6 to 75 years. Of these 61(38.6%) had acute tubular necrosis, 36 (22.7%) acute cortical necrosis and 49(31%) patients had various types of glomerulonephritis (GN). Eight patients (5%) had acute tubulointerstitial nephritis, 3 (1.8%) acute pyelonephritis and one patient had mucormycosis.

This study showed that even in the selected population of biopsied ARF cases, there was a high prevalence of ischemic renal disease. A substantial number of cases in unexplained ARF on renal biopsy were due to various forms of glomerulonephritis.