The prevalence of biopsy-proven
glomerulonephritis varies according to the geographic area, socioeconomic condition, race, age, demography and indication of renal biopsy. This study analyzed the distribution of biopsy-proven renal disease (BPRD) and its changing pattern over a period of 19 years from a tertiary care hospital in south India. All the renal biopsies performed from 1990 to 2008 were reviewed retrospectively. Biopsies were evaluated by light microscopy and immunofluorescence microscopy and also special stains when warranted. A total of 1849 biopsies were analyzed. The mean patient age was 32.27 ± 18.38 (range 10-80) years. The male:female ratio was 1.4:1. The most common indications of renal biopsy were
nephrotic syndrome (49%), followed by
chronic renal failure (13.6%) and rapidly progressive
renal failure (12%). Primary
glomerulonephritis (PGN) comprised 1278 (69.1%) of the total patients. Among the PGN cases, the most common one was
minimal change disease (21.8%), followed by
focal segmental glomerulosclerosis [FSGS (15.3%)],
membranous glomerulonephritis (10%), chronic
glomerulonephritis (9.7%), postinfectious
glomerulonephritis (8.1%), mesengioproliferative
glomerulonephritis (7.5%), diffuse proliferative
glomerulonephritis (6.7%), crescentic
glomerulonephritis (6.5%),
IgA nephropathy [IgAN (6.3%)],
membranoproliferative glomerulonephritis (5.7%), focal proliferative
glomerulonephritis (1.6%) and
IgM nephropathy (0.5). Secondary glomerular disease (SGN) accounted for 337 (18.2%) of the cases. The most common SGN was
lupus nephritis (80.1%), followed by
amyloidosis (8%) and
diabetic nephropathy (6.5%). Tubulointerstitial disease [124 (6.7%)] and
vascular disease [60 (3.2%)] were less common. End-stage changes and miscellaneous disease were found in 37 (2%) and 13 (0.7%) cases, respectively. The incidence of FSGS and IgAN has been increasing since 1999. This study provides descriptive biopsy data and highlights the changing incidence of renal disease which is probably contributed by an increase referral due to increased awareness together with increased manpower and infrastructure.