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J Nephropathol. 2024;13(2): e17362.
doi: 10.34172/jnp.2022.17362

Scopus ID: 85188278278
  Abstract View: 1301
  PDF Download: 203

Original Article

Clinicopathological study of pigment induced nephropathy; a retrospective study

Ranjana Shashidhar Ranade 1 ORCID logo, Atul Desai 2 ORCID logo, Mahabaleshwar Harikrishna Mayya 3 ORCID logo, Sanjay Timmanagouda Patil 2 ORCID logo, Hephzibah Rani 1 ORCID logo, Manjunath Revanasiddappa 2* ORCID logo

1 Department of Pathology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
2 Department of Nephrology, SDM College of Medical Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India
3 Department of Nephrology, Karnataka Institute of Medical Sciences, Hubballi, Karnataka, India
*Corresponding Author: Manjunath Revanasiddappa, Email: doc.r.manjunath@gmail.com, Email: nephrology@sdmmedicalcollege.org

Abstract

Introduction: Rhabdomyolysis and hemolysis cause pigment nephropathy that progresses to chronic kidney disease (CKD) requiring hemodialysis in some patients. As this is a significant financial burden, understanding the etiologies and renal biopsy findings aids in timely diagnosis and optimizing outcomes.

Objectives: We analyzed the etiology, clinicopathological features, and renal outcome of seventeen patients with pigment nephropathy.

Patients and Methods: This retrospective study was conducted from 2018 to 2021. Data on detailed clinical history, laboratory parameters, renal biopsy records and the renal outcome was collected.

Results: Among seventeen patients with pigment nephropathy, the etiology was rhabdomyolysis in 15 patients and hemolysis in two patients. Oliguria was the most common clinical presentation, and all patients presented with acute kidney injury (AKI). Renal biopsy revealed reddish beaded granule and vermiform-like casts in 10, brownish casts with intra-tubular hemosiderin in three, and granular and calcific casts in two patients each. While fourteen patients recovered to normal renal function within three months, one progressed to stage 5 CKD, one had stage 2 CKD, and one died.

Conclusion: In most patients, clinical history did not reveal a direct diagnosis of rhabdomyolysis, and hence one must remain vigilant even in the absence of the classical triad of symptoms.


Implication for health policy/practice/research/medical education:

In a retrospective study, we analyzed the etiology, clinicopathological features and renal outcome of seventeen patients with pigment nephropathy. Our results suggest that mortality is significantly lower in our series compared to other series. It also adds to the literature that early diagnosis and intense follow-up can help complete renal function recovery in most patients with pigment-induced nephropathy.

Please cite this paper as: Ranade RS, Desai A, Mayya MH, Patil ST, Rani H, Revanasiddappa M. Clinicopathological study of pigment induced nephropathy; a retrospective study. J Nephropathol. 2024;13(2):e17362. DOI: 10.34172/jnp.2022.17362.

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Submitted: 24 Mar 2022
Accepted: 27 May 2022
ePublished: 31 May 2022
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