Study of histological spectrum of renal biopsy specimens at a tertiary care center

Abstract

Introduction: Renal biopsy remains the gold standard for diagnosing renal
parenchymal diseases and is essential in guiding treatment and predicting outcomes.
This study aimed to evaluate the histopathological spectrum of renal biopsy
specimens at a tertiary care center over an 18-month period and correlate findings
with clinical parameters.
Materials and Methods: A prospective, cross-sectional observational study was
conducted on 78 patients advised to undergo native kidney biopsy. Inclusion criteria
encompassed patients with suspected renal pathology who consented to biopsy.
Exclusion criteria included renal malignancies, bleeding disorders, and transplanted
kidneys. Biopsies were performed using a spring-loaded Tru-Cut needle under realtime ultrasound guidance. Histopathological evaluation included light microscopy,
immunofluorescence, and electron microscopy where indicated. Clinical,
demographic, and laboratory data were recorded, and descriptive statistical analysis
was performed.
Results: The mean patient age was 37 years, with the majority (53.85%) aged 21–40
years. Males constituted 61.54% of the study population. Nephrotic syndrome
(32.05%) was the most common indication, followed by nephritic syndrome
(21.79%) and rapidly progressive renal failure (16.67%). Among glomerular
diseases, focal segmental glomerulosclerosis (16.67%) and membranous nephropathy
(8.97%) were predominant. Diabetic nephropathy (7.69%) was the most common
cause of chronic kidney disease. Histologically, glomerular obsolescence (47.44%)
and interstitial fibrosis/tubular atrophy (15.38%) were prominent findings. Crescent
formation (2.56%) and arteriolar hyalinosis (16.67%) reflected progressive and
vascular pathologies.
Conclusion: Renal biopsy continues to be indispensable in evaluating kidney
diseases. This study highlights a predominance of glomerular pathologies such as
FSGS and membranous nephropathy in the Indian population, with diabetic
nephropathy and hypertensive vascular changes contributing significantly to chronic
kidney disease. Early diagnosis through biopsy can optimize management and
improve renal outcomes.