Histopathologic spectrum of kidney diseases in Ethiopia: a 3-year retrospective single-center study

The incidence, prevalence, and types of kidney disease in African nations is understudied. Treating and managing acute kidney disease is often approached empirically rather than by kidney biopsy, and underlying causes of kidney failure are largely unknown. Understanding the causes of kidney dysfunction is hampered by a lack of modern techniques and equipment as well as a paucity of well-trained and experienced medical professionals, especially in pathology.

This study examines the types of kidney disease in biopsies from adult and pediatric patients seen from 01/09/2017 to 05/09/2020 at a single medical center in Ethiopia, and compares biopsy diagnosis with and without access to immunofluorescence (IF) technology.

The total number of adequate biopsies was 211 (148 native light microscopy (LM)-only, 48 native LM and IF, 15 transplant); 22 (10.4%) of the 211 adequate biopsies were from pediatric patients. Overall, lupus nephritis was the most frequent diagnosis, rendered in 16.8% of native kidney biopsies, followed by minimal change disease in 12.2% of cases, membranoproliferative-pattern glomerulonephritis (GN) in 11.2%, diffuse proliferative GN in 10.7%, and crescentic GN in 8.2%. Several conditions, including complement-related glomerulopathy, IgA nephropathy, and light chain cast nephropathy were only identified following the introduction of IF microscopy.

The findings provide a small registry of biopsy results and emphasize the importance of advanced techniques in the diagnosis of kidney disease.