Ahmad Zeb Khan, Nisar Anwar, Mohammad Munib, Fahim Shah.
Histological pattern of Glomerulopathies at Khyber Teaching Hospital, Peshawar.
Pak J Med Res Jan ;43(3):117-20.

Objectives: To find out the histopathological pattern of glomerulopathies in children and adult population, who under went renal biopsy in a tertiary care hospital. Design: A prospective study Place and duration of study: Nephrology Department, Khyber Teaching Hospital, Peshawar from June 1999 till June 2001. Patients and methods: Ultrasound guided percutanous renal biopsies were carried out in patients with the following findings: 1) Nephrotic range proteinuria in adults. 2) Non-nephrotic range proteinuria with evidence of hypertension / haematuria / deranged renal function or active sediments on urine microscopy. 3) Steroid resistant nephrotic syndrome in children (patients not responding to steroid in eight weeks time) and 4) Children with nephrotic syndrome who were not tolerant of steroid therapy or were considered for immunosuppressive drugs Results: A total of 130 renal biopsies were done. Out of these 77 were male patients and 53 were females. The most common histopathological lesion among children population was Minimal Change Disease (42.10%) followed by Focal Segmental Glomerulosclerosis (26.31 %) and Membranous GN (15.78%). In the adult, the most frequent entity was Membranoprolifirative GN (22.22%), Membranous GN (20.37%) and Focal Segmental Glomerulosclerosis (16.66%). It was also found that nephrotic range proteinuria was most prevalent in Membranous GN followed by Focal Segmental Glomerulosclerosis. While non-nephrotic range proteinuria was mostly seen in patients with Membranoprolifirative GN. It has been noticed that Crescentic GN is invariably associated with impaired renal function followed in frequency by renal Amyloidosis (60%) and ATN (40%). Conclusion: In adult population Membranoprolifirative GN is the leading histopathological entity in our set up followed by Membranous GN. Similarly in children Minimal Change Disease is the most commonly encountered glomerulopathy followed by Focal Segmental Glomerulosclerosis. Percutanous renal biopsy helps the nephrologist to find out the underlying histopathology for accurate diagnosis leading to improved management plan.

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