Pattern of glomerular disease in Nepal: A single-center experience

Area of Science:

• Nephrology
• Pathology
• Internal Medicine

Background:

• Glomerulonephritis (GN) is a leading cause of end-stage renal disease in Nepal.
• Understanding the clinical and histological patterns of GN is crucial for effective management.

Purpose of the Study:

• To determine the clinical presentation and histological patterns of GN in Nepalese patients.
• To compare kidney biopsy findings with and without immunofluorescence (IF).

Main Methods:

• Retrospective analysis of 398 GN patients undergoing kidney biopsy from 2000-2009.
• Clinical data and Light Microscopy (LM) findings were analyzed.
• Immunofluorescence (IF) data was incorporated for a subset of patients.

Main Results:

• Nephrotic syndrome (69%) and acute nephritic syndrome (14.4%) were common presentations.
• Without IF, Mesangial Proliferative GN (MesPGN) and Membranoproliferative GN (MPGN) were frequently diagnosed.
• With IF, Minimal Change Disease (MCD) (23.2%) and Focal Segmental Glomerulosclerosis (FSGS) (18%) were the most prevalent glomerular lesions.

Conclusions:

• GN predominantly affects young adults in Nepal, often presenting as nephrotic syndrome.
• Immunofluorescence significantly alters the diagnosis of glomerular lesions, highlighting potential over-diagnosis of MesPGN and MPGN by LM alone.
• MCD and FSGS are the most common histological diagnoses in GN patients in this cohort.