STUDY ON FREQUENCY OF TYPES OF RENAL GLOMERULOPATHIES CAUSING NEPHROTIC SYNDROME IN LOCAL POPULATION

Abstract

Objective: To study the spectrum and relative frequency of kidney biopsy findings in patients undergoing kidney biopsy for nephrotic syndrome at a tertiary care centre in Lahore. Methods: This single-centre cross-sectional study was carried out in the Department of Pathology, Fatima Memorial Hospital, Lahore, over three months (15th January, 2026 to 14th April 2026). Seventy adequate native kidney biopsies from patients presenting with clinical and biochemical features of nephrotic syndrome were included by non-probability consecutive sampling. Specimens were examined by light microscopy with haematoxylin–eosin, periodic acid–Schiff, Masson trichrome, Jones methenamine silver and Congo red stains, together with direct immunofluorescence for IgG, IgA, IgM, C3 and C1q. Each biopsy was reported independently by two consultant histopathologists. Data were analysed in SPSS version 26; continuous variables are presented as mean ± standard deviation and categorical variables as frequencies and percentages. Results: The mean age was 35.5 ± 13.2 years (range 2–64); 38 patients (54.3%) were female and 32 (45.7%) were male. All patients had proteinuria above 3.5 g/24 h (mean 5.37 ± 0.76 g), and serum albumin was below 3 g/dL in 63 (90.0%). Of the 70 biopsies, 57 (81.4%) showed a specific glomerular diagnostic pattern, 9 (12.9%) showed non-specific glomerular changes, and 4 (5.7%) showed predominantly non-glomerular or non-diagnostic findings. Focal segmental glomerulosclerosis (FSGS) was the most frequent primary glomerular diagnosis (17, 24.3%), followed by lupus nephritis (11, 15.7%) and membranous nephropathy (7, 10.0%). Among  secondary glomerular diseases, lupus nephritis was the predominant diagnosis. Conclusion: Focal segmental glomerulosclerosis was the predominant primary glomerular diagnostic pattern in this cohort and Lupus nephritis was the predominant secondary glomerular disease. Because several patterns cannot be assigned confidently to a primary or secondary aetiology from the available data, results are presented by diagnostic certainty rather than forced primary/secondary classification.