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.