Abstract
ETIOLOGICAL AND CLINICAL PROFILE OF GLOMERULAR DISEASES IN ADULTS

*Dr. Vinoj and Dr. Veerapandian

ABSTRACT

Background: Glomerulopathies constitute one of the important causes of morbidity and mortality. The objective of this study is to document the clinical and etiological profile of patients with Glomerular diseases by performing renal biopsy in them at Tirunelveli Medical college Hospital, Tirunelveli. Methods: We conducted a prospective study on 50 randomly selected patients of either sex, age >15 years who presented to our Medicine department proteinuria or hematuria. Patients with these features were clinically evaluated and subjected to tests like serum total protein urine PCR, Lipid profile, BUN and renal imaging. If results were suggestive of glomerular disease percutaneous renal biopsy was done to characterize the exact pathology. Results: Among the 50 patients evaluated 26 were males and 24 males were females. The most common glomerular pathohlogy encountered was IgA nephropathy 13/50 (26%). Among patients with IgA nephropathy proteinuria was seen in all the patients(100%), 31% had oliguria 38.5% had pedal edema, 54% had facial puffiness, 31% had extra renal manifestation but none (0%) had hematuria. Second common pathology encountered was Endocapillary prolifetaive glomerulonephritis(EPGN) 9/50 (18%). This EPGN was seen in 8 cases of post infective glomerulonephritis and 1 case of lupus nephritis. Membranous nephropathy and lupus nephritis each accounted for 5/50(10%), followed by minimal change disease and proliferative glomerulonephritis each accounting for 4/50 (8%). It was followed by focal segmental glomerulosclerosis is present in 3/50(6%) followed by diabetic nephropathy, acute cortical necrosis and acute cell mediated rejection each accounting for 2/50 (4%). Finally Diffuse proliferative glomerulonephritis was seen in 1/50 (2%). Conclusion: According to this study among the 50 patients evaluated IgA nephropathy was the most common condition noted. Proteinuria was present in all patients with IgA nephropathy while Volume overload state was present in nearly half of them. Second common condition was post infective glomerulonephritis. Urine quantification of protein remains a simple yet reliable test for picking up clinically significant glomerular diseases.

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