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Trends in Glomerular Diseases in Northwest India: Has COVID-19 Altered the Diagnostic Landscape?

Abhishek P Singh1, Jaydeep R Damor2, Pankaj Beniwal3

  • 1Senior Resident, Department of Nephrology, Sawai Man Singh (SMS) Medical College, Udaipur, Rajasthan, India, Orcid: https://orcid.org/0000-0003-1893-0305.

The Journal of the Association of Physicians of India
|November 24, 2025
PubMed
Abstract

Insights

IgA nephropathy is now the most common primary glomerular disease in Northwest India, surpassing minimal change disease. This study highlights evolving trends in kidney disease and the impact of the COVID-19 pandemic on renal biopsies.

Area of Science:

  • Nephrology
  • Pathology
  • Epidemiology

Background:

  • Glomerular diseases significantly contribute to chronic kidney disease globally.
  • Minimal change disease (MCD) was historically prevalent in Northwest India.
  • Evolving diagnostics and the COVID-19 pandemic may have impacted disease patterns.

Purpose of the Study:

  • To analyze the clinicopathologic spectrum of glomerular diseases from 2020-2024.
  • To compare current data with historical data (2008-2013).
  • To assess the pandemic's effect on biopsy activity and disease distribution.

Main Methods:

  • Retrospective analysis of 925 renal biopsies (2020-2024) and comparison with 622 biopsies (2008-2013).
  • Utilized light microscopy and immunofluorescence staining.
  • Categorized diagnoses into primary glomerular disease (PGD), secondary glomerular disease (SGD), and others, recording clinical presentations like nephrotic syndrome (NS) and acute kidney injury (AKI).

Main Results:

  • Glomerulonephritis remained dominant (93.9%) with a significant shift in PGD distribution.
  • IgA nephropathy increased to 15.4%, becoming the leading PGD, while MCD decreased to 8.1%.
  • Focal segmental glomerulosclerosis (FSGS) rose to 12.4%, diabetic nephropathy (DN) to 3.1%, and biopsy volume temporarily declined during the pandemic.

Conclusions:

  • Significant evolution in glomerular disease patterns observed in Northwest India.
  • Highlights the need for improved access to renal biopsies and advanced diagnostic tools.
  • Emphasizes the importance of establishing a national renal biopsy registry in India.

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