Pattern of pediatric renal disease observed in native renal biopsies in Pakistan

In the absence of a national pediatric renal biopsy registry, there is a paucity of information on the pattern of childhood renal disease observed in Pakistan. A few studies previously reported are based on light microscopic study of renal biopsies only. This is the first study from this country which is based on light, immunofluorescence and electron microscopic study of native renal biopsies.

We undertook a retrospective review of native renal biopsies performed in children who presented with signs and symptoms related to renal diseases at the Sindh Institute of Urology and Transplantation during the period of July 1995 to June 2008. The renal biopsy diagnoses were categorized into the following groups: primary glomerulopathies, secondary glomerulopathies, tubulointerstitial diseases, renal vascular diseases, hereditary diseases and unclassified.

Glomerulopathies were the commonest diagnosis, representing 93.34% of all biopsies. Primary glomerulopathies accounted for 87.64% and secondary glomerulopathies for 5.7%. When primary glomerulopathies were further analyzed, minimal change disease was the leading histopathological pattern, found in 29.4% of all biopsies, followed by focal segmental glomerulosclerosis, seen in 21.8% of cases. Among secondary glomerulopathies, lupus nephritis was the commonest, followed by amyloidosis and hemolytic uremic syndrome. Tubulointerstitial and vascular diseases were rare, representing 2.8% and 0.8% of all biopsy diagnoses, respectively.

Our pattern of biopsied pediatric renal pathology is similar to that reported recently in series with similar biopsy indications from other parts of the world.