Histo-pathological changes in kidneys in autopsies of flame burns at a tertiary care center in North Western India: an autopsy based study at SMS medical college Jaipur (2015-2016)

Vivek Kumar Mangare, Rakesh Kumar Punia


Background: Burn injury is associated with an intricate patho-physiological response with rapid involvement of various organ systems and which in turn impact the patient with multisystem disruption. These damages can be attributed to the alteration occurring at the tissue and cellular level leading to the histological changes in the renal tissue.

Methods: The main aim of this study was to document the histo-pathological changes in kidneys of fatal cases of flame burns. This study was hospital based observational descriptive study carried out at mortuary of SMS medical college and attached hospitals, Jaipur, Rajasthan, India to study and document the histo-pathological changes in the fatal cases due to flame burns.

Results: In this study, most common histo-pathological finding in kidneys was cloudy degeneration followed by congestion. Acute tubular necrosis of proximal convoluted necrosis was most commonly observed during 3 to 7 days of mortality (18 cases) followed by mortality during 0 to 48 hours. Acute tubular necrosis of distal convoluted tubules was most commonly observed during 3 to 7 days followed by mortality during 0 to 48 hours.

Conclusions: This study revealed that cloudy degeneration and acute tubular necrosis were the hallmark changes in burn patients which were most prominent at 3-7 days after sustaining burn injuries. This reflects the role of immediate management provided to the patient during this period with timely and effective fluid restoration and it possibly will change the prognosis of patients.


Acute tubular necrosis, Burns, Renal tissue, Renal failure

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Olivera-Martinez I, Viallet JP, Michon F, Pearton DJ, Dhouailly D. The different steps of skin formation in vertebrates. Int J Dev Biol. 2004;48:107-15.

World Health Organization. Burns Fact Sheet (Internet); (Posted September 2016; cited 2017 January 9). Available at:

Taylor FW, Gumbert JL. Cause of death from burns: role of respiratory damage. Ann surg. 1965;161(4):497-501.

Zhao ZD, Changes in organ water content in patients with postburn multiple organ failure. Chinese J Plastic Surg Burns. 1990;6(1):50-2.

Pruitt B. Protection from excessive resuscitation: Pushing the pendulum back. J Trauma. 2000;49(1):567-73.

Goodpastor WE, Levenson SM. A Clinical and Pathological Study of the kidneys in patients with thermal burns. Surg Gynecol Obstet. 1946;82:652-70.

Cernea D, Bold A, Mateescu GO, Simionescu C. Microscopic assays regarding the renal damage following a post-combustional shock. Rom J Morphol Embryol. 2005;46(4):291-4.

Hakimov EA, Shakirov BM, Umarov S. Kidneys condition in multiorgan inefficiency resulting from burn disease. J Med Biolog Sci Res.2015;1(2):10-3.

Shinde AB, Keoliya AN. Study of burn deaths with special reference to histopathology in India. Indian J Basic Applied Res. 2013;2(8):1153-9.

Sevitt S. Distal tubular and proximal tubular necrosis in the kidneys of burned patients. J Clin Pathol. 1956;9(4):279-94.

Bhetariya BV, Desai NJ, Gupta B D, Patel PN. Profile of kidney histopathology in cases of burns - emphasis on acridine orange fluorescence study and to explore its forensic utility. J Clin Diagnostic Res. 2016;10(4):1-5.

Argamaso RV. Pathology, mortality and prognosis of burns: a review of 54 critical and fatal cases. Canad Med Ass J. 1967;97:445-9.