Clinicopathological spectrum of renal biopsies at a tertiary care hospital in South India: a cross-sectional study

Nikhil Kumar D. G.; Madhusudan Pai; Manana Gowda; Yeshavanth G.

doi:10.18203/2320-6012.ijrms20263378

Authors

Nikhil Kumar D. G. Department of General Medicine, S.S. Institute of Medical Sciences, Davangere, Karnataka, India
Madhusudan Pai Department of General Medicine, S.S. Institute of Medical Sciences, Davangere, Karnataka, India
Manana Gowda Department of General Medicine, S.S. Institute of Medical Sciences, Davangere, Karnataka, India
Yeshavanth G. Department of General Medicine, S.S. Institute of Medical Sciences, Davangere, Karnataka, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263378

Keywords:

Renal biopsy, Membranous nephropathy, IgA nephropathy, Diabetic nephropathy, Glomerulonephritis, Clinicopathological correlation

Abstract

Background: Renal biopsy provides definitive tissue-based diagnosis in patients with suspected intrinsic renal disease, and its spectrum varies geographically and by referral pattern. Data from South Indian tertiary-care centers remain limited. This study evaluated the clinical presentation, biochemical profile, and histopathological spectrum of renal biopsies at a tertiary-care hospital in Davangere, Karnataka.

Methods: This hospital-based cross-sectional study included 30 consecutive patients undergoing native percutaneous renal biopsy between July 2022 and June 2023. Demographic, clinical, and laboratory parameters were recorded, biopsies evaluated by light microscopy, and histopathological diagnoses assessed descriptively against presenting renal syndromes.

Results: Mean age was 39.9±16.3 years; 17 (56.7%) were male. Pedal edema was present in 25 (83.3%) and hematuria in 15 (50.0%); 13 (43.3%) had diabetes and 9 (30.0%) hypertension. Asymptomatic microscopic hematuria/proteinuria, macroscopic hematuria, and nephrotic syndrome each accounted for 6 (20.0%), while nephritic syndrome, rapidly progressive glomerulonephritis, and acute kidney injury each accounted for 4 (13.3%). Membranous nephropathy was the commonest diagnosis (9, 30.0%), followed by IgA nephropathy (6, 20.0%); diabetic nephropathy and acute tubular injury/necrosis each accounted for 4 (13.3%). Six patients (20.0%) had nephrotic-range proteinuria, and among 13 diabetic patients, only 4 had diabetic nephropathy while 9 had other renal lesions.

Conclusions: The renal biopsy spectrum in this cohort was heterogeneous, with membranous nephropathy and IgA nephropathy the most frequent diagnoses. The frequent occurrence of alternative renal lesions among diabetic patients highlights the value of biopsy when the clinical diagnosis does not adequately explain the renal presentation. These findings provide locally relevant clinicopathological data from South India.

References

Uezono S, Hara S, Sato Y, Komatsu H, Ikeda N, Shimao Y, et al. Renal biopsy in elderly patients: a clinicopathological analysis. Ren Fail. 2006;28(7):549-55.

Yim T, Kim Y, Park S, Lim JH, Jung HY, Cho JH, et al. Patterns in renal diseases diagnosed by kidney biopsy: A single-center experience. Kidney Res Clin Pract. 2020;39(1):60-9.

Su S, Yu J, Wang Y, Wang Y, Li J, Xu Z. Clinicopathologic correlations of renal biopsy findings from northeast China: A 10-year retrospective study. Medicine (Baltimore). 2019;98(23):e15880.

Donadio JV Jr, Grande JP. IgA nephropathy. N Engl J Med. 2002;347(10):738-48.

Bhawane A, Pasari AS, Tolani P, Balwani MR. Spectrum of biopsy-proven native kidney disease in Central India. Saudi J Kidney Dis Transpl. 2022;33(5):688-92.

Mittal P, Agarwal SK, Singh G, Bhowmik D, Mahajan S, Dinda A, et al. Spectrum of biopsy-proven renal disease in northern India: A single-centre study. Nephrology (Carlton). 2020;25(1):55-62.

Chowdhary PK, Kumar AV, Kale SA, Nayak S, Joshi P, Badge RP, et al. Histopathological spectrum of kidney biopsy in Central India: A two-center retrospective study. Indian J Nephrol. 2024;34(4):379-82.

Ghimire M, Vaidya S, Upadhyay HP. Clinicodemographic profile of kidney diseases in a tertiary hospital of Central Nepal, Chitwan: A descriptive cross-sectional study. JNMA J Nepal Med Assoc. 2020;58(227):459-64.

Sharma RK, Singh V, Sood V, Dogra PM. Spectrum of glomerular diseases in North India and its clinicopathological correlation – An observational study. J Mar Med Soc. 2024;26:41-6.

Gangdev AN, Kandari S, Kant R, Dhoot DK, Garg S, Cheriyan A, et al. Clinicopathological spectrum of glomerular disorders in adult versus elderly patients: a prospective observational study from a tertiary care centre in North India. Int J Res Med Sci. 2026;14(9):3941-6.

Lin Z, Xie S, Wang W, Hong T, Jiang B, Chen C, et al. Changes in the spectrum of kidney diseases: a 14-year single-center retrospective renal biopsy study from southeast China. PeerJ. 2025;13:e19302.

Josephine S, Barathi G, Susruthan M, Balasubramanian S. A spectrum of biopsy-proven renal disorders and their clinicopathological correlation in elderly population from a tertiary care center in South India. Cureus. 2021;13(8):e17031.

Di Paolo S, Fiorentino M, De Nicola L, Reboldi G, Gesualdo L, Barutta F, et al. Indications for renal biopsy in patients with diabetes. Joint position statement of the Italian Society of Nephrology and the Italian Diabetes Society. Nutr Metab Cardiovasc Dis. 2020;30(12):2123-32.

Luciano RL, Moeckel GW. Update on the native kidney biopsy: Core Curriculum 2019. Am J Kidney Dis. 2019;73(3):404-15.