Clinicopathological Analysis of Kidney Diseases in University Children’s Hospital in Damascus

Abstract

Background & Objective: Renal biopsy is an important tool for establishing the histological diagnosis, and guiding therapy of renal diseases. There is great variation in epidemiology of renal histopathology all over the world, so we performed this study to identify the distribution of histopathological types of renal diseases in patients in Children’s Hospital in Damascus, and describe the clinicopathological correlation, and its effect on the choice of treatment, for establishing the important indications for renal biopsy.

Materials & Methods: Descriptive cohort study carried out in Children’s Hospital in Damascus, included all patients admitted and had kidney biopsy, in a period of 6 years, from January 2011 to December 2016. We collected the data, which were discussed and compared with similar  studies in the literature.

Results: The study includes 105 patients had kidney biopsy, with slight male dominance (52%) and median age 6 years, ranged from 40 days to 14 years. All patients tolerated the biopsy well, without important complications. Nephrotic Syndrome was the commonest  indication for kidney biopsy (62% of all patients), and Steroid-resistant Nephrotic Syndrome was the commonest indication for biopsy in Nephrotic Syndrome patients (51%). Focal Segmental Glomerulosclerosis was the commonest histopathological diagnosis in Nephrotic Syndrome patients (45%), then Minimal Change Disease (32%). In Glomerular Isolated Hematuria persistent > 6 months cases ( 14 cases), the biopsy was normal in (50%), and IgA Nephropathy in (29%). In Systemic Lupus Erythematosus cases (13 cases), the commonest histopathological type was Lupus Nephritis type IV (38%).

Conclusion: Renal biopsy is a safe and important procedure in children, which help in guiding therapy of some renal diseases, and the commonest indication for a biopsy in children remains Nephrotic Syndrome, and the commonest histopathological diagnosis in Nephrotic Syndrome patients is Focal Segmental Glomerulosclerosis. Biopsy had no therapeutic effect in Glomerular Isolated Hematuria persistent > 6 months cases, so it is not urgent procedure in this cases. It is important to do biopsy in Systemic Lupus Erythematosus cases in children, which help in guiding therapy and follow it.