Clinical, Biochemical and Histopathological Features of Adult Nephrotic Syndrome – A Cross Sectional Study

Abstract

Background and Objectives ABSTRACT There is currently little information in literature about the pattern of nephrotic syndrome in adults in our country. The occurrence of different histopathological lesions in adult patients with nephrotic syndrome is different from that seen in paediatric population. The objectives of the present study were to know the clinical features, biochemical and histopathological spectrum in the adult onset nephrotic syndrome and to correlate the clinical and biochemical parameters with histopathological diagnosis. Methods The present one year cross sectional study was conducted in the Department of Nephrology and Medicine, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum, on 30 patients clinically diagnosed to have adult onset nephrotic syndrome during the period of January 2007 to December 2007. Data was collected by relevant history, clinical examination, relevant biochemical investigation and renal biopsy. Results Out of 30 patients 19 ( 63.33% ) were males and 11 ( 36.66% ) were females. Mean age was 31.1 years. Primary glomerular disease was predominant and accounted for 76.6%. Of which MCN was the most common histological lesion ( 60% ) , followed by FSGS ( 17% ) . Among secondary glomerular disease amyloid was the most common ( 57% ) followed by SLE ( 42% ) . The commonest presentation was pedal oedema, puffiness of face and oliguria. 33.33% patients X had hypertension, of which 50% were MCN, 20% were SLE and 10% were FSGS. 33.33% had haematuria of which 40% were MCN, 20% were FSGS and 20% were MN. All patients had nephrotic range proteinuria, hypoalbuminemia and high lipid profile with low HDL levels. Conclusion and interpretation MCN was the most common primary glomerular disease followed by FSGS and amylodosis is the most common secondary glomerular disease followed by SLE. The common presentation was pedal oedema, puffiness of face and oliguria. Hypertension was more prevalent among MCN and FSGS. Renal biopsy is of paramount importance in diagnosing underlying histopathology adult nephrotic syndrome.