Pattern of Renal Histopathological Findings in Children: A Single Center Study

Introduction: A well-known diagnostic tool for determining kidney diseases in paediatrics is renal biopsy. It aids in selection of precise therapeutic approaches for several renal diseases. Aim: To explore the indications and histopathological patterns of renal diseases in children in a tertiary care center in Odisha, India. Materials and Methods: A retrospective study involving renal biopsies were performed on children aged <= 14 years between January 2010 and July 2018. All renal biopsies were studied under light and immunofluorescent microscopy. The clinical characteristics and histological diagnosis pertaining to each case during the study period were retrieved from medical records and analysed. Results: A total of 443 biopsies were considered for analysis. The mean age was 5.94 years (range 4 months-14 years) with a predominance of boys (62.97%). The most common indication for renal biopsy was Nephrotic Syndrome (NS) (79.9%) followed by lupus nephritis (5.19%), Acute Kidney Injury (AKI) (3.16%) and haematuria (2.25%). Steroid Dependent Nephrotic Syndrome (SDNS) was the most frequent indication among all NS children. Minimal Change Disease (MCD) was the most common histopathological finding in NS which constituted 47.63% followed by Focal Segmental Glomerulosclerosis (FSGS) 22.12%. The biopsy report of the children with lupus nephritis showed the disease progression to stage IV. Most common primary glomerulonephritis was MCD while secondary glomerulonephritis was lupus nephritis. Conclusion: MCD was the most common histological finding. The present study provides largest data on Biopsy Proven Renal Disease (BPRD) in children from eastern India published till date.