Clinico-Pathological Spectrum of Glomerulonephritis: A Study from a Tertiary Care Hospital in Bangladesh

Abstract

Background: Glomerulonephritis (GN) is a significant cause of chronic kidney disease, yet evidence from Bangladesh remains limited. This study aimed to describe the clinicopathological spectrum of GN among patients undergoing native kidney biopsy at a tertiary hospital. Methods: A retrospective review was conducted at Sher-E-Bangla Medical College, Barisal, Bangladesh, including 67 patients aged ≥12 years with biopsy-proven GN. Demographic, clinical, laboratory, and histopathological data were analyzed using descriptive statistics. Results: The median age of the patients was 30 years (IQR: 21–47), with 40 patients (59.7%) being female. Most patients (86.6%) had a normal body mass index (BMI). Diabetes mellitus and hypertension were present in 4.5% and 13.4% of the patients, respectively. Nephrotic presentations occurred in 38 patients (56.7%), while nephritic presentations were observed in 29 patients (43.3%). The median serum creatinine level was 1.02 mg/dL, and the estimated glomerular filtration rate (eGFR) was 80 mL/min/1.73 m². Hypoalbuminemia (2.5 g/dL), hypercholesterolemia (321 mg/dL), and proteinuria (4.8 g/day) were common findings. Low complement C3 and C4 levels were noted in 48.5% and 46.9% of the patients, respectively. Antinuclear antibody (ANA) was positive in 28.9% of cases, anti-double-stranded DNA (anti-dsDNA) in 36.4%, and anti-neutrophil cytoplasmic antibody (ANCA) in 40% (2 out of 5). Histopathology revealed focal segmental glomerulosclerosis (FSGS) (22.4%) and lupus nephritis (22.4%) as the most common diagnosis, followed by minimal change disease (MCD) (13.4%), membranoproliferative glomerulonephritis (MPGN) (10.4%), and infection-related glomerulonephritis (11.9%). Nephrotic presentations predominated in FSGS (36.8%) and MCD (15.8%), while nephritic presentations were more frequent in lupus nephritis (34.4%) and infection-related glomerulonephritis (21.9%). Conclusion: In this cohort, focal segmental glomerulosclerosis and lupus nephritis were the leading causes of GN. The distinct clinicopathological correlations emphasize the diagnostic value of renal biopsy and highlight the need for larger studies in Bangladesh.