Histopthological spectrum of renal biopsies in pediatric population: An update

Objective: To determine the histological spectrum and indications of renal biopsies in pediatric population from birth to 16 year of age and to delineate any change in histological pattern with time and age at tertiary care hospital in Karachi Study Design: Cross sectional study Place and Duration of Study: This study was carried out at Aga khan University Hospital Karachi over a period of 7.5 years from January 2006 to July 2014. Materials and Methods: A retrospective review of the computerized database of the histopathology department of Aga khan University hospital (AKUH) was carried out on children from birth to 16 years of age who underwent renal biopsy. All renal biopsy specimens were processed, cut and stained and evaluated under light microscopy and immune fluorescence technique. The indication and findings of these biopsies and demographic data such as age and sex were identified. Frequencies and percentages were used for categorical variables and mean ± standard deviation for quantitative variables. SPSS version 19.0 for statistical analysis. Results: Mean age was 11.5 years ± 3.5 years with an age range from 3 months to 16 years with majority of the patients over 10 years of age. Out of 128 patients 79(61.7%) were male and 49(38.3%) were female with a ratio of 1.6: 1. The most common indication observed for renal biopsy was Nephrotic syndrome seen in 75(58.6%) cases with 36 (28.1%) being steroid resistant variety followed by steroid sensitive 25 (19.5 %). Other indications observed were Nephritic syndrome 16 (12.5%), renal failure 13(10.2%) and lupus nephritis for classification 11(8.6%). The most frequent renal disease observed was focal segmental glomerulosclerosis (FSGS) 38(29.7%). Others being minimal change disease 19(14.8%), membranous glomerulonephritis 12 (9.4%). The most frequent biopsyfinding in all age group was FSGS. Conclusion: The distribution of renal diseases in pediatric age group described is similar to that described in national and international literature with some differences observed. This study provides updated epidemiological information on childhood renal diseases.