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Pediatric Renal Biopsies in India: A Single-Centre Experience of Six Years
Kamal V Kanodia1, Aruna V Vanikar1, Lovelesh K Nigam1
1Department of Pathology, Laboratory Medicine, Transfusion Services and Immunohematology, G.R. Doshi and K.M. Mehta Institute of Kidney Diseases and Research Centre and Dr. H.L. Trivedi Institute of Transplantation Sciences, Asarwa, India.
Insights
This study analyzed 335 pediatric renal biopsies in India, finding nephrotic syndrome and primary glomerulonephritis to be the most common conditions. The data aids in understanding childhood kidney diseases and developing treatment guidelines.
Area of Science:
- Pediatric Nephrology
- Renal Pathology
- Epidemiology of Kidney Diseases
Background:
- Renal biopsy is crucial for diagnosing pediatric kidney diseases, offering diagnostic precision, prognostic value, and therapeutic guidance.
- Understanding the epidemiology of renal diseases in children is essential for public health initiatives and clinical management.
Purpose of the Study:
- To describe the indications for renal biopsy in children.
- To detail the histopathological patterns of kidney diseases diagnosed via biopsy.
- To analyze the epidemiology of renal diseases in the pediatric population in India.
Main Methods:
- A single-center retrospective study of 346 pediatric renal biopsies performed between January 2008 and December 2013.
- Analysis of 335 adequate renal biopsies from children aged 14 years or younger.
- Data collection included indications, histopathological findings, and patient demographics.
Main Results:
- Nephrotic syndrome (46.2%) and urinary abnormalities (41.19%) were the most frequent indications for biopsy.
- Primary glomerulonephritis (GN) predominated (81.79%), with mesangial proliferative GN (MePGN) being the most common pattern.
- Secondary GN (16.12%) included lupus nephritis as the most frequent type; tubulointerstitial nephritis was seen in 2.08%.
Conclusions:
- This study provides valuable epidemiological data on renal diseases in Indian children.
- Findings highlight the prevalence of primary glomerulonephritis and specific patterns like MePGN.
- The data can inform the development of a national renal disease registry and therapeutic guidelines for pediatric kidney diseases in India.
Background:
Renal biopsy is a well-established diagnostic modality for the assessment of kidney diseases in children. It can provide diagnostic precision and prognostic value and guide in therapeutic options for many renal diseases.
Objectives:
This report describes the indication, histopathological patterns, and epidemiology of renal diseases in children in India.
Patients And Methods:
This is a single-center study on renal biopsies performed between January 2008 and December 2013 in 346 children (age ≤ 14 years).
Results:
Eleven (3.17%) biopsies were inadequate, and 335 biopsies were considered for analysis. The mean age was 7.91 ± 3.04 years with a predominance of males (68.1%). Nephrotic syndrome (46.2%) was the most common indication, followed by urinary abnormality (41.19%), acute nephritic syndrome (10.74%), and chronic renal failure (1.79 %). Primary glomerulonephritis (GN) was predominant (81.79%), and secondary GN constituted 16.12% of the biopsies. Primary GN included mesangial proliferative GN (MePGN), IgM nephropathy, focal segmental glomerulosclerosis, minimal change disease, IgA nephropathy, membranoproliferative GN, membranous nephropathy, crescentic GN, and post-infectious GN. Secondary GN revealed lupus nephritis, hemolytic uremic syndrome, amyloidosis, and hypertensive nephropathy. Tubulointerstitial nephritis was observed in 2.08%. The most common histological pattern of primary GN was MePGN (20%) and in secondary GN it was lupus nephritis (7.76%).
Conclusions:
The present study provides data on the epidemiology of renal diseases in children in India and will be helpful for developing a national registry and devising therapeutic guidelines.
