A study of the clinico-histologic patterns of adult glomerulonephritides in south western Nigeria

Abstract

Background: Glomerulonephritis (GN) is one of the major causes of chronic kidney disease (CKD) worldwide. It remains the leading cause of End Stage Kidney Disease (ESRD) in many developing countries. It is presumed to be responsible for more than half of patients with ESRD in Africa. The clinical course, pattern and presentation of glomerular disease varies world-wide and may be due to differences in genetics of underlying population or exposure to putative antigens or agents that induce or trigger these responses. This study evaluated the clinicopathologic patterns of glomerular diseases in a homogenous black population in the hope that it will provide a more robust data on glomerulonephritides in our black population. The study is aimed at describing the pattern of biochemical abnormalities and histopathologic variants of glomerulonephritides observed in adult patients in our environment.
Methods: The study was cross-sectional inature involving seventy (70) consecutive adult patients with features of glomerulonephritis who presented at the nephrology and other medical out-patient department (MOPD) clinics, general out-patient department (GOPD) as well as the hospital staff clinic. A structured 4-part proforma was drawn up and administered to obtain information on sociodemographic, clinical, anthropometric parameters and laboratory investigation results. Relevant laboratory tests and investigations were performed. Renal function was assessed and renal biopsy performed after obtaining written informed consent. The renal tissues obtained were subjected to light microscopy and immunoperoxidase staining with IgA, IgM, IgG and C3 antibodies and the results interpreted.
Results: A total of seventy patients participated and completed the study. Three (3) patients had inadequate renal tissue for histologic diagnosis hence data analysis was based on the remaining sixty seven (67) patients.The age range of the study population was between 18 and 65 years with a mean age of 28.43 (±10.33) years. Forty- five males (67.2%) and twenty-two females (32.8%) participated in the study population with an overall male to female ratio of 2:1. The most common clinical manifestation was nephrotic syndrome which was present in 41 (61.2%) of the study population. The most common histological diagnosis was focal segmental glomerulosclerosis (FSGS) seen in 30 patients (44.8%).
Conclusion: Focal segmental glomerulosclerosis (FSGS) was the commonest histological type found in these patients with glomerulonephritis, while the commonest clinical presentation was nephrotic syndrome.