Pattern of Glomerulonephritis and changing trends at a Tertiary care centre.

Ezhilarasi, A (2009) Pattern of Glomerulonephritis and changing trends at a Tertiary care centre. Masters thesis, Madras Medical College, Chennai.


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INTRODUCTION : Numerous inflammatory and non-inflammatory diseases affect the glomerular and lead to alteration in glomerular permeability, structure and function. Many glomerular diseases come under the genomic title glomerular nephritis (GN) which implies that there is immune pathogenesis. Not all glomerular diseases are caused by immune pathogenesis and here to be considered in its differential diagnosis, particularly important are diabetic nephropathy and amyloidosis as well as hereditary nephropathy, most commonly Alport syndrome. Glomerular nephritis may be primary, restricted in clinical manifestations to the kidney or it may be part of multisystem disease, most frequently systemic lupus erythematosis and vasculitis. While the likelihood of a patient having glomerulo nephritis can be estimated with varying degree of confidence from the clinical setting and laboratory test it cannot ultimately be diagnosed without histological evidence of renal cortical tissue. The underlying cause of most glomerular diseases reminds unknown since knowledge of etiology and pathogenesis is rather limited. The most reliable classification of glomerular diseases based on clinical pathological and laboratory evidence of the disease. Different studies by various authors in western countries as well as in India have shown varying prevalence of glomerular diseases. OBJECTIVES OF THE STUDY : 1. To study and analyse the clinical pattern of Glomerulonephritis and to observe the changing pattern of Glomerulonephritis in our centre during two study periods, i.e. 2000-2006 and 2007-2008. 2. To compare our data with the data of other centre. MATERIALS AND METHODS : The study was done as prospectively from Jan 2007- Dec 2008. Retrospective data from Jan 2000-Dec 2006 were retrieved from case record. Study centre : Department of Nephrology , Government General Hospital , Madras Medical College , Chennai – 600 003 Plan of study: All patients who had clinical, laboratory and histopathological features of Glomerular disease were analysed. Detailed history and Clinical examination were done to find out evidence of volume status, BP measurements and Funduscopic examination followed by basic laboratory investigation like urine analysis complete blood count, coagulation profile, renal function test, liver function test, Chest X–Ray, Ultrasonographic examination of the Abdomen with done and basic serelogical and immunological workup like HBsAg, anti HCV, HIV, ASO Titre and ANA were done. After informed consent Ultrasound guided Renal Biopsy was done with spring loaded semi-automatic gun. All biopsies were evaluated by Light microscopy and immunoflorescence. Patients were grouped according to age, gender, presence of Hypertension, renal function and their results were analysed. CONCLUSIONS : Our studies show that the most common primary glomerular disease is FSGS, followed by PIGN, IGAN, MCNS and MGN, in that order, respectively. There is increased incidence of FSGS and PIGN during the year 2007-08. The mean age of presentation for FSGS and MGN was lower during 2007-08. The occurrence of FSGS, PIGN and MCN was seen more in younger age group, while in elderly patients, IgA nephropathy was common primary glomerular disease. Our studies have shown decreased incidence of MCD, FSGS, IgA nephropathy and MGN, and increased incidence of lupus nephritis compared to CMC studies. The incidence of Crescentic GN and diabetic nephropathy was similar in both the studies.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Pattern of Glomerulonephritis ; changing trends ; Tertiary care centre.
Subjects: MEDICAL > Nephrology
Depositing User: Kambaraman B
Date Deposited: 11 Jul 2017 04:00
Last Modified: 11 Jul 2017 04:00

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