Volume: 11 Issue: 1
Year: 2023, Page: 35-40, Doi: https://doi.org/10.47799/pimr.1101.06
Received: March 10, 2022 Accepted: Feb. 20, 2023 Published: Feb. 20, 2023
Background: Chronic Kidney disease is a major public health concern. In India, the burden of chronic Kidney disease cannot be assessed properly. In such case autopsy study becomes an indispensible part of Medicine.
Aim: To explore the spectrum of changes seen in kidneys and correlating it with clinical findings.
Material & Methods: A descriptive study of kidneys of Medico legal autopsies from January 2019 – December 2019 was conducted. A total of 665 Medico legal autopsies were received, in 73 cases kidneys were not received, while 23 kidneys had autolytic change. A total of 569 Kidneys were included in the study. The Gross and Microscopic features along with special stains were studied and the cause of death was noted.
Results: A total of 569 kidney autopsies were assessed. On Gross 26% were congested, 13% had contracted granular kidney. On Histopathological examination, Non specific changes were seen in 53.4%, specific nephropathological lesions noted were chronic pyelonephritis (8.9%), acute tubular necrosis (5.6%), sickle cell nephropathy (4.7%), tubercular nephritis (1.2%).
Conclusion: Infective etiology was the commonest cause, along with sickle cell nephropathy. It has provided the spectrum of lesions seen in this area along with correlation of cause of death. Screening for diabetes mellitus and hypertension would lead to early detection and timely management which would reduce chronic kidney diseases.
Keywords: Autopsy, Chronic Kidney Disease, Sickle cell nephropathy.
Start, R D, Firth, J A, Macgillivray, F & Cross, S S . 1995. How declining clinical necropsy rates reduced the contribution of necropsy to Medical research ?j. Clinical pathology 48:402–404.
Varughese, S & Abraham, G . 2018. Chronic kidney disease in India A clarion call change. Clin J American society 13:1–3.
Levey, A S, Atkins, R, Coresh, J, Cohen, E P & Collins, A J . 2007. chronic kidney disease as a global public health problem approach and initiatives- a position statement from kidney disease Improving global outcomes. Kidney Int 72:247–259.
Schiffrin, E L, Lipman, M L & Mamm, J F . 2007. Chronic Kidney disease effects on the cardiovascular system. Circulation 116:85–97.
Agarwal, S K & Srivastava, R K . 2009. Chronic Kidney disease in India challenges and solutions. Nephron clinPract 111:197–203.
Henviksen, K J . 2017. Assesment of Kidneys in adult autopsies. Journal of diagnostic histopathology 23(3):117–125.
Rajapurkar, M M, John, G T & Kirplani, A L . 2012. what do we Know about chronic kidney disease in India first report of the. Indian CKD Registry. B M C nephrology 13:10.
Kaur, A, Bodal, V K & Gong, P . 2018. Histopathological spectrum of kidney lesions in Autopsy- A study of 100 cases. Journal 0f Medical science and clinical research 6(2):962–965.
Patel, S, B R Rajalakshmi & Manjunath, G V . 2016. Histopathologic findings in Autopsies with emphasis on interesting and incidental findings- A Pathologist Perspective. J Clinical Diagnostic research 10(4):8–12.
Paueksakoh, Paisit & B Agnes . 2014. Autopsy renal Pathology Fogo surgical. Pathology 7:321–325.
Alpers, Charles E & Chang, Anthony . The Kidney. Robbins and Coltran pathologic Basis of Disease 9 th edition. 898–955
Padmanabhan, A, Gohil, S & Gadgil, N M . 2017. chronic renal failure : An Autopsy study. Saudi Journal Kidney Dis Transplant 28(3):545–551.
Sandhu, V, Puri, A & Singh, N . 2017. Histomorphological spectrum of lesion in An autopsy study. Annals of Pathology and Laboratory Medicine 4(4):410–414.
Yadav, Sns & Bhattachrya, A . 2019. Histomorphological study of kidney lesions in Autopsy- An original eight year study. IOSR journal of dental and Medical sciences 18(5):50–54.
Hailemariam, S, Walder, M & Burger, H . 2001. Renal pathology and premortem clinical presentation of Caucasian patients with AIDS. An autopsy study from the era prior to antiretroviral therapy. Swiss Med Wkly 131:412–429.
Eastwood, J B, Corbishley, C M & Grange, J M . 2000. Tuberculosis and the kidney. J Am society Nephrol 12:1307–1314.
Sl, Kate & Lingowar, D P . 2002. Epidemiology of sickle cell disorders in the state of Maharashtra. International journal Human Genetic 2(3):161–167.
Darbari, D S, Kpel, & Faget, P . 2006. Circumstances of death in adult sickle cell disease Patients. American Journal of hematology 81(11):858–863.
Patel, M M, Modi, J P, Sm, Patel & Patel, R D . 2007. Vasocclusion by sickled RBC’S in 5 autopsy cases of sudden death. Indian Journal of Pathology and Microbiology 50:914–916.
Anjana, R M, Pradeepa, R, Deepa, M, Datta, M & Sudha, V . 2011. Prevalence of diabetes and prediabetes ( impaired fasting glucose and impaired glucose tolerance) in Urban and Rural India. Pase 1 results ofthe Indian Council of Medical Research- INDIA Diabetes ( ICMR-India B) study. Diabetologia 54:3022–3029.
Anupama, Y J & Uma, G . 2014. Prevalence of chronic disease among adults in a rural community in South India results from the kidney disease screening (KIDS) project. Indian J Nephrolo 24:214–235.
Jacob, S R & Causes, Ravendran R . 2019. Co Morbidities and current status of chronic Kidney disease : A Community perspective from North Kerala. Journal of Family Medicine and primary 8(9):2859–63.
Verna, P P . 2015. CKD prevalence in India. Indian journal of Nephrology 25(3):133–135.
Nzegwu, M A, Aligbe, J U & Ogunbiyi, F . 2009. Causes and renal morphological changes in chronic renal failure, retrospective study of 50 autopsy cases. Int J Medical science 1:168–72.
Jha, V & Garcia- Gacia, G . 2013. Chronic Kidney disease : global dimension and perspective. Lancet 382:260–72.
Vasaikar M, Damle R, Ruikar K, Madavi S. Pathological changes in Kidney Autopsies from North Maharashtra –A Descriptive Study. Perspectives in Medical Research. 2023;11(1):35-40 DOI: 10.47799/pimr.1101.06