“Morphological Spectrum of Kidney Lesions-An Autopsy Study”

Abstract

Introduction: Renal diseases are responsible for great deal of morbidity and mortality. Chronic kidney disease (CKD) is now a global health crisis with prevalence rate of 8-16% world wide.The increased prevalence of kidney disease is a consequence of the accumulation of risk factors such as HTN, DM, dyslipidemia and obesity. The medicolegal autopsy plays an important role in establishment of final diagnosis  and determine the immediate cause of death.Histopathological Examination (HPE) of renal tissue in autopsy provides useful information for preventing chronic renal disease that tends to be silent and go undiagnosed.

Objective: To study the morphological spectrum and frequency distribution of renal lesions in autopsy specimens.

Materials and methods: The medico legal autopsy   kidney specimens of aged above 18 years received in our Department of pathology from February 2018 to November 2021 were studied. The relevant clinical history and autopsy findings were taken before HPE.Formalin fixed specimen was grossed, processed and sections were stained with routine hematoxylin and eosin stain. Microscopic examinations of all the sections were done by pathologist. Special stains like Periodic Acid Schiff (PAS),Jones Methenamine Silver (JMS), Masson’s Trichrome (MT) were done wherever necessary.

Results: The age range of the autopsies was between 22 and 80 years. Out of 55 cases, 41 (74.54%) of the  were males, while 14(25.45%) were females. The microscopic findings are of normal histology in 8(14.54%) cases. Out of remaining 47(85.45%) cases which had nephropathological findings, non-glomerular lesions 36(65.45%) were higher than glomerular lesions  9(16.36%). Glomerular lesions included focal segmental glomerular sclerosis-3(5.45%), focal nodular glomerular sclerosis-1(0.55%) and glomerular hyalinisaton-3(5.45%) cases. Tubular and interstitial lesions included   6(10.9%) cases of Acute tubular necrosis (ATN), 9(16.36%) Chronic pyelonephritis, 5(9.09%)  Chronic pyelonephritis (CPN) with hydronephrosis and 7(12.72%) Chronic interstitial nephritis. In 5(9.09%) cases, simple renal cyst was found as associated findings. Renal arteriosclerosis was observed in 4(7.27%) cases.

Conclusion: Our study provided in-depth data of morphological pattern and frequency distribution of renal lesions in medico legal autopsy specimens. Thus autopsy study has become an indispensable part of medicine which aids in identifying the risk factors, consequences of disease, patient management along with improved patient care and also reduces the mortality due to renal pathology.