Clinicopathological spectrum of biopsy-proven renal diseases in a tertiary hospital

Background: Renal disorders require a renal biopsy for accurate diagnosis, effective treatment planning, and assessing the extent of active and chronic histologic changes. Objective: To evaluate the spectrum of renal diseases diagnosed by renal biopsy and its clinical correlation. Methodology: This was a four-year retrospective study carried out from January 2019 to December 2022 at Ain Shams University Hospitals. Patients’ demographic data and clinical presentations were extracted from available data sheets. All specimens were examined using light and electron microscopy and stained with immunofluorescence or immunohistochemical techniques. The results were organized according to the most recent classification system. Results: A total of 1851 renal biopsy specimens were studied (52.4% males), with a mean patient age of 38.43±14.83 years. 346 patients (18.7%) presented nephrotic syndrome, and 322 patients (17.4%) had lupus nephritis as a secondary complication. The majority of patients with glomerulonephritis had hypertensive nephrosclerosis; 694 patients (37.5%) had membranous glomerulonephritis. 124 patients (6.7%) were diagnosed with IgA nephropathy. Most of them presented with asymptomatic hematuria. 52 patients (2.8%) were diagnosed with thrombotic microangiopathy, all of them presented with acute kidney injury. 35 patients (1.9%) were diagnosed with tubulointerstitial diseases; however, it was associated with other renal pathology diagnoses. Conclusion: The most frequently observed diagnosis was hypertensive nephrosclerosis, with lupus nephritis being the most prevalent form of secondary glomerulonephritis. Membranous glomerulonephritis was the most common kind of primary glomerulonephritis.