HISTOLOGICAL PATTERN OF RENAL BIOPSY IN ACUTE KIDNEY INJURY
Objective: The objective of this study was to determine the histological pattern of acute kidney injury in local tertiary
Material and methods: This descriptive was performed in department of medicine hayat abad medical complex Peshawar
from January 2014 to December 2016. After detail history examination and investigations, all diagnosed patients
of acute kidney injury were included in this study after informed consent. Well trained consultants performed the renal
biopsy by use of an ultrasound guided automated biopsy gun. Two samples were taken one for histopathology and
another for immune fluorescence. A sample was considered adequate if the biopsy yielded at least 10 glomeruli at light
microscopy, one glomerulus at immunofluorescence microscopy. All patient were management according to standard
treatment guidelines. Serological markers were also studied in clinically relevant cases.
Patient fulfilling the Kidney Disease Improving Global Outcome (KDIGO) following definition of acute kidney injury, Acute
kidney injury is defined as any of the following: increase in serum creatinine (sCr) by≥0.3 mg/dl (≥26.5 μmol/l) within
48 hours; or an increase in serum creatinine to ≥1.5 times baseline, which is known or presumed to have occurred
within the preceding 7 days; or a urine volume <0.5 ml/kg/h for 6 hours.14
Results: A total of 81 patients were recruited in this study. Male gender dominated 56% female patients were 44%.
Average age was 34 years ranging from 15 years to 78 years. Pauci-immune crescentic glomerulonephritis was the
leading cause of acute renal failure reported of 24% biopsy specimens, followed by acute tubular necrosis found in
16% patients. Post-infectious glomerularonephritis were third prominent cause of acute renal deterioration accounting
up to 12% renal biopsies followed by interstitial nephritis and IgA Nephropathy contributing 10% each. Anti-Glomerular
basement membrane nephritis and focal segmental glomerular nephritis were documented in 6%. Of other minor
causes Henoch-Scholein like Purpura, systemic lupus erythematosis, light chain nephritis and nephrocalcinosis were
reported in 4%each.
Conclusion: Renal biopsy is an important investigation in establishing the diagnosis of acute renal failure. Pausi-immune
glomerulopathies and acute tubular necrosis are most common histological patterns in acute kidney injury.