Clinicopathological profile and outcomes of pediatric glomerular diseases: A tertiary care experience

Glomerular diseases in children are significant cause of morbidity and mortality, causing significant burden on health care system. Data regarding the outcomes of paediatric patients with glomerular diseases in association with clinicopathological findings is critical to understand the management plan and prognosis. To determine clinical spectrum, histopathological findings and outcome of children with glomerular disease who underwent kidney biopsy.

Cross sectional retrospective study conducted at nephrology department of National Institute of Child Health from January 2016 to December 2020. All children aged one to 18 years who underwent percutaneous kidney biopsy were included. Data recorded from the files including demographics, clinical presentations, diagnosis, histopathological findings, post biopsy complications and their outcome at last follow-up were noted. Data were analyzed using SPSS version 23.

Seventy children with mean age of 6.85±3.54 were studied. Males were predominant (56.9%). Most common presentation was edema (95.8%) followed by oliguria (77.7%) and hypertension (44.4%). Most common indication for kidney biopsy was steroid resistant nephrotic syndrome (SRNS 56.9%) followed by rapid progressive glomerulonephritis (RPGN16.7%). Two most common histopathological findings were focal segmental glomerulosclerosis (FSGS 33%) and minimal change disease (MCD 26%). Biopsy complications were observed in 21%. Outcome of our study showed that majority (75.7%), had preserved renal functions whereas, 5.6 % developed chronic kidney disease.

Common presentations were edema, oliguria and hypertension. SRNS and RPGN were common indications for kidney biopsy. FSGS and MCD were common histopathological findings. Outcome was normal kidney functions in majority and few developed chronic kidney disease.