Initial Experience of Renal Biopsy at a New Nephrology Center in Eastern Nepal

We report the initial experience of renal biopsy at a new nephrology center in eastern Nepal. A prospective analysis of patients who underwent renal biopsy from January 2016 to December 2018 at the department of nephrology, Nobel Medical College Teaching Hospital, Biratnagar, Nepal was done. One hundred and fifty-six patients underwent renal biopsy, mean age of the patients was 32.8 ± 14.6 years, and 88 (56.4%) were female. The most common indication of renal biopsy was nephrotic syndrome (NS) (71 patients, 45.5%), followed by nephritic syndrome (63 patients, 40.3%). Renal biopsy was done in 15 patients (9.6%) who had hypertension (HTN) with renal impairment and normal size kidneys, in five diabetic patients (3.2%) when there was suspicion of nondiabetic kidney disease and in one patient (0.6%) with unexplained acute renal failure. The most common histological finding in NS was primary membranous nephropathy (MN), 23 (32.3%) followed by primary focal segmental glomerulosclerosis, 17 (23.9%). Lupus nephritis (LN) contributed to 50.7% (32 patients) of total nephritic syndrome and Class IV LN was the most common (34.3%) pathological class. Immunoglobulin A nephropathy (10 patients, 66.6%) was the most common cause of HTN with renal impairment with normal size kidneys. Among five diabetic patients, one case each of kappa chain restricted cast nephropathy and primary MN was identified. A heterogeneous pattern of renal diseases identified in our study should provide an impetus to the nephrology community of Nepal to start a national renal biopsy registry.