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J Nephropathol. 2017;6(4): 304-308.
doi: 10.15171/jnp.2017.49

Scopus ID: 85036553981
  Abstract View: 3330
  PDF Download: 1148

Original Article

Histologic patterns of primary adult onset nephrotic syndrome and their clinical characteristics; a single center study from South India

Gurudev Konana 1, Vijay Varma 1*, Mahesh Eswarappa 1, Sonika Puri 1, Gireesh Mathihally 1, Rakesh Madhyastha 1, Sujeeth Reddy 1, Vijaya Mysorekar 2, Clement Wilfred 2

1 Department of Nephrology
2 Department of Pathology, M.S. Ramaiah Medical College, Bengaluru, India
*Corresponding Author: *Corresponding author: Vijay Varma, , Email: vijay.varma8@gmail.com

Abstract

Background: The histologic pattern causing nephrotic syndrome (NS) and their clinical outcome varies depending on age, sex, race, socioeconomic status and geographic location. There has been a changing trend in the histologic spectrum of NS in the last few decades, in India as well as worldwide.
Objectives: The objective of the present study was to see the histologic spectrum of adult NS in our institution and to compare it with data from other centers.

Patients and Methods: All adults (≥ 18 years) with nephrotic range proteinuria who underwent renal biopsy from August 2012 to February 2015, were consecutively included in this prospective study. NS caused by diabetes and other secondary glomerular diseases were excluded.

Results: Eighty (65.4%) patients were males and 42 (34.4%) were females. The median age at the time of biopsy was 36 years (interquartile range [IQR]: 24.8–45). The most common lesions were minimal change disease (MCD) in 40.2%, membranous nephropathy (MN) in 24.6% and focal segmental glomerulosclerosis (FSGS) in 16.4% of the patients. MCD was observed mostly commonly in the age group 18-35 years and MN was seen mostly
commonly in age group 36-55 years.

Conclusions: MCD still continues to be leading cause of NS in south Indian adults as evidenced from previous studies from this region. Other common causes include MN and FSGS. The incidence of MPGN is on the decline.


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

Our study is a showcase of the different histologic spectrum of primary nephrotic syndrome (NS) in South Indian adults. Minimal change disease (MCD) is the most common lesion found in our patients as opposed to data from other developed nations where focal segmental glomerulosclerosis (FSGS) is an emerging entity and the most common lesion. Also the incidence of membranoproliferative glomerulonephritis was very low in our population which probably is indicative of better infectious control practices that we use these days. Our study highlights that heterogeneity in the histologic spectrum of NS is influenced by region, race, genetic and environmental factors.

Please cite this paper as: Konana G, Varma V, Eswarappa M, Puri S, Mathihally G, Madhyastha R, et al. Histologic patterns of primary adult onset nephrotic syndrome and their clinical characteristics; a single center study from South India. J Nephropathol. 2017;6(4):304-308. DOI: 10.15171/jnp.2017.49.

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Submitted: 28 Dec 2016
Accepted: 11 Apr 2017
ePublished: 05 May 2017
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