Publication:

Clinicopathological spectrum of renal biopsies at a tertiary care hospital in South India: a cross-sectional study

Background Renal biopsy provides definitive tissue-based diagnosis in patients with suspected intrinsic renal disease, and its spectrum varies geographically and by referral pattern. Data from South Indian tertiary-care centers remain limited. This study evaluated the clinical presentation, biochemical profile, and histopathological spectrum of renal biopsies at a tertiary-care hospital in Davangere, Karnataka.

Methods This hospital-based cross-sectional study included 30 consecutive patients undergoing native percutaneous renal biopsy between July 2022 and June 2023. Demographic, clinical, and laboratory parameters were recorded, biopsies evaluated by light microscopy, and histopathological diagnoses assessed descriptively against presenting renal syndromes.

Results Mean age was 39.9±16.3 years; 17 (56.7%) were male. Pedal edema was present in 25 (83.3%) and hematuria in 15 (50.0%); 13 (43.3%) had diabetes and 9 (30.0%) hypertension. Asymptomatic microscopic hematuria/proteinuria, macroscopic hematuria, and nephrotic syndrome each accounted for 6 (20.0%), while nephritic syndrome, rapidly progressive glomerulonephritis, and acute kidney injury each accounted for 4 (13.3%). Membranous nephropathy was the commonest diagnosis (9, 30.0%), followed by IgA nephropathy (6, 20.0%); diabetic nephropathy and acute tubular injury/necrosis each accounted for 4 (13.3%). Six patients (20.0%) had nephrotic-range proteinuria, and among 13 diabetic patients, only 4 had diabetic nephropathy while 9 had other renal lesions.

Conclusions The renal biopsy spectrum in this cohort was heterogeneous, with membranous nephropathy and IgA nephropathy the most frequent diagnoses. The frequent occurrence of alternative renal lesions among diabetic patients highlights the value of biopsy when the clinical diagnosis does not adequately explain the renal presentation. These findings provide locally relevant clinicopathological data from South India.