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Background: There is a geographical variation in pattern of kidney diseases due to multiple factors. Renal biopsy is being performed to establish diagnosis of renal diseases. There are only a few biopsy registries which leads to paucity of information. This study was done to evaluate the spectrum of biopsy-proven renal diseases in a tertiary care hospital in southern India. Materials and methods: Renal biopsy records over 2 decades (2000-2020) performed in the Department of Nephrology in a tertiary care hospital in India were analyzed, and clinicopathological correlation was made. Results: Total of 4,532 renal biopsies were evaluated in our study after excluding inadequate biopsy samples. Of which males were 58 and 48% were females. Mean age in our study was 38.6 ± 31.4 years. The most common clinical presentation in our study was nephrotic syndrome (37.2%). On histology, the most common diagnosis was primary glomerulonephritis (49.9%), followed by secondary glomerular diseases (22%), tubulointerstitial (20.8%), and vascular diseases (3.3%). Minimal change disease (12.8%), diabetic nephropathy (11.3%), and acute tubulointerstitial diseases (11.2%) were the three most common histological diagnoses in our study. Conclusion: Nephrotic syndrome was the most common clinical presentation in our study. Minimal change disease was the most common histological diagnosis in our study. There is a need for a uniform nationwide renal biopsy registry in India and even regional renal biopsy registries to analyze the changing trends of renal diseases over time frame and to analyze regional differences in trends of renal diseases., (© Journal of the Association of Physicians of India 2024.)

The aim of the study was to determine the various histopathological lesions in human immunodeficiency virus (HIV) patients with renal dysfunction and to establish clinicopathological correlation. Over a period of two years from January 2008 to March 2010, 27 HIV positive patients with renal dysfunction were subjected to renal biopsy. Of the 27 patients, 23 were males and four were females (85.2% males, 14.8% females). Mean age was 38.2 ± 10.36 (range 20 -- 60) years. The probable mode of acquisition of HIV infection was sexual in 22 patients (81.5%). Thirteen patients (48%) had nephrotic proteinuria. The CD4 count ranged from 77 to 633/microliter. The kidneys were of normal size in 19 (70.4%) and bulky in eight (29.6%) patients. Thirteen patients required renal replacement therapy. Eleven patients had acute tubule-interstitial lesions (40.7%) while 15 (55.5%) had glomerular lesions. The various glomerular lesions were, focal segmental glomerulosclerosis in five, amyloidosis in three, diffuse proliferative GN in two, and membranoproliferative glomerulonephritis (GN), membranous GN, minimal change disease, diabetic nephropathy, crescentic GN, and thrombotic microangiopathy were seen in one each. None of the clinical or laboratory variables, except hypertension, was found to predict glomerular versus non-glomerular lesions on biopsy. In conclusion we show that a variety of glomerular and tubulointerstitial lesions can be seen on renal histology. Hence, renal biopsy is indicated in renal dysfunction associated with HIV for making proper diagnosis and therapy. [ABSTRACT FROM AUTHOR]

Nephrotic syndrome can be rarely due to inherited disorders of enzymes. One such variety is lecithin cholesterol acyltransferase deficiency. It leads to accumulation of unesterified cholesterol in the eye and other organs. We report a case of nephrotic syndrome with cloudy cornea and hypocholesterolemia with foam cells and lipid deposits on renal biopsy. Awareness about this rare disease may help in the early institution of specific measures to prevent progression to end-stage renal disease. [ABSTRACT FROM AUTHOR]

The author reflects on the potential useof urine indices in determining the volume status associated with nephrotic edema.