The histological pattern of glomerulonephritis in Sri Lankan patients with the nephrotic syndrome

Abstract

A histopathological study of Glomerulonephritis in Sri Lanka has not been documented. Percutaneous tru-cut biopsics were done to obtain renal tissue in 124 patients with clinically and biochemically confirmed nephrotic syndrome. The tissue was processed for light microscopy and stained with Haemetoxylin-Eosin, Periodic Acid Schiff and Silver Methanamine in all instances. Of the 124 samples there were, Minimal change glomerulonephritis 16 = 12.9%, Membranous glomerulonephritis 24 = 19.4%, Membrano proliferative glomerulonephritis 20 = 16.1%, Proliferative (Mesangial cell, Endocapillary 40 = 32.3% extracapillary) Focal Proliferative 01= 0.8% ,Focal ,Glomerulosclerosis 01 = 0.8%, Amyloidosis 01 = 0.8%, Systemetic - Lupus 04 = 3.2%, Not cfassified 17 = 13.7% Electron microscopy and immunoflorescence microscopy was not available. Histological evaluation of all adult nephrotics and steroid resistant childhood nephrotics is important for prognostication and therapy. Specific therapy is used in Membrano Proliferative Glomerulonephritis and in SLE with glomerulonephritis and diffuse crescentic glomerulonephritis. It is also important in order to avoid blind steroid therapy in other types of proliferative glomerulonephritis. A biopsy is also necessary in adult nephrotics to establish a diagnosis of minimal lesion type prior to the positive use of steroids. Histological evaluation would provide a better basis for managing glomerulonephritis and hopefully delay the prognession to advanced renal failure.