International Journal of Applied Research
Vol. 1, Issue 9, Part I (2015)
Original Article - Study of Etiological Profile of Nephrotic Syndrome in Adults
Aims and objectives- The aims and objectives of the study were: To study the clinical and biochemical profile of adults presenting with nephrotic range proteinuria. And To determine the pathology responsible for the adult nephrotic syndrome by renal biopsy. Material and methods- A prospective study was conducted on patients of either sex, age >18 yrs who presented to the medicine department of G. R. Medical college and JA Group of hospitals, Gwalior during the period of June 2008 to November 2010 with proteinuria of > 3gm/24hours. Patients with these features were subjected to clinical examination and biochemical investigations. Renal biopsy was done to characterize the lesion responsible for the proteinuria. The following were the inclusion and exclusion criteria used for selection of candidates for renal biopsy. Results- Out of the total 54 cases studied, males contributed to around 64.8% of the cases. The overall male to female ratio was 1.8:1.Maximum number of cases was in the age group of 18-27 contributing to 51.8% of the total cases. The mean age at presentation was 31.7+ 8.5 years (range was 18 – 65 years). At the time of presentation, Edema was seen in 96.3 %. 33. 3% cases had hypertension. The mean MAP was 96.1 +16.5 mmHg (range 73.3 – 120 mmHg).The mean duration from onset of symptoms to renal biopsy was 6.83 months. Present study revealed that out of 54 cases, 63% cases had hypercholesterolemia, 85.2% cases had hypoalbuminemia, 39% cases had increased levels of serum creatinine and 37% cases had hematuria at the time of presentation. The mean hemoglobin was 11.5+1.8 gm%. (Range 6.7 – 15.9 gm%). The mean serum Creatinine was 1.3+0.8 mg/dl (range 0.4 – 3. 62 mg/dl). The mean 24 hr Urinary Protein were 5.6 + 1.3 gm/day (range was 3–28.1 gm/day).The mean serum Albumin was 2.4+ 0.4 gm/dl (range was 0.9 – 3.6 gm/dl). The mean serum cholesterol was 268.3+173.2 mg/dl (range was 142 – 514 mg/dl). Among the total 54 cases studied, the most common lesion responsible for the nephrotic syndrome in adults was Focal Segmental Glomerulosclerosis (FSGS). FSGS was the lesion responsible in 37% of the cases. The next common lesion was Membranous Glomerulonephritis (MGN) which contributed to around 18.5% of the cases. The third most common lesion in our study was Renal Amyloidosis which constituted 14.8% of the total. Membranoproliferative Glomerulonephritis (MPGN) was found in 13% of the cases. Lupus Nephritis (LN) was identified as the cause of adult nephrotic syndrome in 9.3 % cases. Minimal Change Disease (MCD) was responsible for adult nephrotic syndrome in 5.5% of the cases with adult nephrotic syndrome. Only one among the 54 cases studied came out to be IgA Nephropathy (IgAN) which contributed to 1.8%. Conclusion- All these facts stress the need for a proper histopathological diagnosis and avoidance of unnecessary delay in making a confirmatory diagnosis wherever needed by a renal biopsy.
How to cite this article:
Sanjay Dhawale, Satyam Singh jayant, Rakesh gaharwar. Original Article - Study of Etiological Profile of Nephrotic Syndrome in Adults. Int J Appl Res 2015;1(9):545-549.