Analysis of renal biopsy in Trat Hospital.

Abstract

Background : Glomerular disease is a common problem faced in clinical practice in Thailand. It could be definitely diagnosed by performing kidney biopsy. The knowledge of epidemiology of biopsy-proven glomerular disease provides useful information in clinical practice. There are several epidemiologic studies in many countries however, they yield differing results in terms of clinicopathologic correlations and clinical response.

Objective : To identify the prevalence of primary, secondary glomerular diseases and analyze clinical response of common glomerular diseases in Trat Hospital.

Method : Descriptive retrospective study of percutaneous kidney biopsies during June 2004 - May 2005 was performed. A total of 36 consecutive native kidney biopsies in adult patients were analyzed. Outpatient medical records were reviewed about clinical response after treatment.

Results : A total of 36 native kidney biopsy data were collected during this period. The most common indication for kidney biopsy was nephrotic syndrome (65.7 percent), followed by nephrito-nephrotic syndrome (25.7 percent), diabetic with unusual renal manifestations (5.7 percent), and rapidly progressive glomerulonephritis (2.9 percent). Primary glomerular diseases were more common than secondary glomerular disease (71.4 vs. 28.6 percent). The most common primary glomerular disease was IgM nephropathy (48 percent), followed by focal segmental glomerulosclerosis (16 percent), minimal change disease (16 percent). The most common secondary glomerular disease was lupus nephritis. Post biopsy complication occurred in 2.7percent (gross hematuria).For clinical response to steroid therapy, IgM nephropathy was poorer steroid
responsive than minimal change disease, but no difference in blood pressure, renal function and urinary protein excretion between the two groups.