www.ijcmr.com Section: Medicine International Journal of Contemporary Medical Research ISSN (Online): 2393-915X; (Print): 2454-7379 | ICV: 77.83 | Volume 5 | Issue 5 | May 2018 E55 A Study on Clinico Pathological Spectrum of Nephrotic Syndrome in Adult Patients in a Teaching Hospital in Eastern India Anirban Sarkar 1 , Faizanul Haque 2 ORIGINAL RESEARCH ABSTRACT Introduction: Nephrotic Syndrome is one of the important causes of end stage renal diseases in adult patients worldwide. Current research aimed to study prospectively the clinico- pathological spectrum of glomerular disease pattern in adult nephrotic syndrome patients in a teaching hospital in Eastern India. Material and Methods: This non randomised prospective study was conducted on 72 indoor patients in the Department of Medicine presenting with nephrotic range of proteinuria (≥3 gm/24 hours) at a teaching hospital during the period of July 2016 to April 2018. Adult patients (≥18 years) with proteinuria ≥3gm/24 hours were included in the study whereas patients with coagulopathy, contracted kidney, drug induced and iatrogenic nephropathy, unilateral solitary kidney, acute pyelonephritis, vesico ureteric refux and eGFR < 15 ml/ min/1.73m 2 were excluded. Result: Out of 72 cases studied 48 were male mostly in the age group between 18 to 50 years presented with edema (100%),oliguria (8.3%), hypertension (36%), diabetes (25%), dyslipidemia (70%), hematuria (35%), anemia (65%), hypocomplimentemia (10%) and active urinary sediment (27.8%). TSH were normal in all cases and none was reactive to viral markers (HBsAg, Anti HCV antibody, HIV 1 and 2 antibody). 22% cases had renal insuffciency (Sr.Cr >1.4 mg/ dl). Conclusion: Primary Glomerulonephritides commonly MGN were found in majority of cases. Keywords: Adult Nephrotic Syndrome, MGN, FSGS, Lupus Nephritis, Renal Biopsy, MCD, Light Microscopy, Immunofurescence, Amylodosis. INTRODUCTION Nephrotic syndrome is a clinico - biochemical condition consisting of heavy protinuria and hypoalbuminaemia associated with dyslipidaemia, edema, hypertension and minimal hematuria. It is frequently complicated with increased susceptibility to infections, thromboembolism, altered carbohydrate and lipid metabolism and loss of binding proteins in urine and resultant endcrinopathy. Underlying common pathology of damage to glomerular basement membrane and selective proteinuria can be readily diagnosed in the modern era of percutaneous biopsy combined with sophisticated electron microscopy and immunofuroscence study. Though Nephrotic Syndrome is commonly found in Paediatric group of patients but it contributes a signifcant burden to the adult age group also. Despite considerable advances in health care, glomerular disease constitutes one of the leading causes of renal failure resulting in considerable morbidity and mortality. The patterns of the glomerular diseases are different in different countries and are changing with time within the same country, probably due to better infection control, changes in environmental pollution, increased awareness of the disease and changes in life expectancy. The purpose of this study was to analyse the spectrum of nephrotic syndrome in adult patients in Eastern India. 1,2 Study aimed to observe the clinical profle of adult patients with nephrotic syndrome, to analyse the biochemical parameters of these patients, to determine the underlying pathological spectrum with renal biopsy and to observe presence of associated co morbidities MATERIAL AND METHODS A non randomised prospective study was conducted on 72 indoor adult patients (age >18years) with nephrotic range of proteinuria (≥ 3gm/ 24 hours) in a teaching hospital in Eastern India during July 2016 to April 2018. They undergone detailed clinical examination and biochemical investigation (serum creatinine, BUN, LFT, CBC, Lipid Profle, TSH, HBsAg, Anti HCV antibody, HIV 1 and 2 antibody, vasculitis profle (ANA, pANCA, cANCA, RF), serum complement factor (C3 and C4), serum protein eletrophoresis and complete urinalysis). UPCR as an alternative of 24 hours quantitative urinalysis was done in oliguric patients. We excluded patients with coagulopathy, contracted kidney, drug induced and iatrogenic nephropathy, unilateral solitary kidney, acute pyelonephritis, vesico ureteric refux and eGFR < 15 ml/min/1.73m2. Percutaneous renal biopsy for light microscopy and immunofuorescence studies were done under real time USG guidance in all patients after informed consent and in presence of professional back-up. Only biopsy specimens containing four or more glomeruli were considered appropriate. In all cases, a minimum of 20 sections were obtained and stained with hematoxylin-eosin, periodic acid-Schiff (PAS), trichrome and Jones' Silver stain. 1 Assistant Professor, Department of Medicine, 2 Senior Resident, Department of Otolaryngology and Head Neck Surgery, ESIC PGIMSR and Medical College and ODC (EZ) Corresponding author: Dr. Faizanul Haque, Flat No.- 2H, Tower No.-21, Genexx Valley, Joka, Kolkata- 700104, India How to cite this article: Anirban Sarkar, Faizanul Haque. A study on clinico pathological spectrum of nephrotic syndrome in adult patients in a teaching hospital in Eastern India. International Journal of Contemporary Medical Research 2018;5(5):E55-E58. DOI: http://dx.doi.org/10.21276/ijcmr.2018.5.5.41