Change of pattern of histopathological analysis of kidney biopsy specimens in Kuwait; a five-year prospective study

Introduction: Among the different geographical areas, glomerulonephritis (GN) varies in incidence due to socioeconomic conditions, ethnicity, genetic variability and environmental factors.Objectives: Our study aimed to determine change of pattern of histopathological analysis of kidney biopsy specimens in Kuwait over the preceding five years.Patients and Methods: In a prospective study, we analyzed the clinical and histopathological data of ۲۱۷ kidney biopsies that performed over the preceding five years during the period from November ۲۰۱۴ to November ۲۰۱۹. An automated gun was used to perform kidney biopsies percutaneously guided by ultrasound. The kidney biopsy specimens were processed for light microscopy and immunofluorescence examination. Kidney function tests, urine protein/day, virology, immunology profiles, age, gender, indications for kidney biopsy and histopathological findings were recorded for analysis.Results: Primary GN was reported in ۶۳.۱%, secondary GN was reported in ۳۱.۸% and tubulointerstitial disease was reported in ۵.۱% of the ۲۱۷ kidney biopsies studied. Among primary GN, immunoglobulin A nephropathy (IgAN) was the most common lesion (۱۹.۴%), followed by focal and segmental glomerulosclerosis (FSGS, ۱۶.۶%), and membranous nephropathy (MN, ۱۴.۷%). Among biopsies that showed secondary GN, lupus nephritis was the most common (۱۱.۹۸%), followed by diabetic nephropathy (DN) (۵.۱%) and membranoproliferative glomerulonephritis (MPGN) (۴.۶%). Among biopsies that showed tubulointerstitial disease, acute interstitial nephritis was the most common lesion (۴.۶%), followed by chronic interstitial nephritis (۰.۴۶%).Conclusion: The present study revealed that IgAN is the most common primary GN, followed by FSGS, while lupus nephritis is the most common secondary GN, followed by DN. Our previous study in Kuwait, revealed that MN was the most common primary GN, followed by IgAN, while lupus nephritis was the most common secondary GN, followed by hypertensive glomerulosclerosis.

Keywords:

Kidney biopsy , Glomerulonephritis , Immunoglobulin A nephropathy , Lupus nephritis