Clinical and histopathological characteristics of patients with glomerulonephritis syndrome attending renal unit at Muhimbili National Hospital in Dar es Saalam, Tanzania.

Abstract

ABSTRACT Background: The histologic pattern of specific glomerulopathies and their related clinical presentation vary according to age, sex, race, socioeconomic status and geographic location. The underlying histopathological pattern of patients presenting with glomerulonephritis syndrome in Tanzania is virtually unknown. Objectives: This study was set to determine different Biochemical and histopathological patterns of glomerulonephritis syndrome at Muhimbili National Hospital in Dar es Salaam Tanzania. Patients and Methods: Descriptive hospital based case series, all adults from (18yrs and above) with proteinuria and hematuria who underwent renal biopsy from April 2017- December 2017 were consecutively recruited into this study.Patients infected with HIV, hepatitis B virus and hepatitis C virus were excluded due to resources constraints. Results: 55% participants with glomerulopathies were enrolled for this study, but40 were eligible for percutaneous renal biopsy. Two-thirds of participants were female (67.5%) with mean age (±SD) of 32.7 (9.8) years. on clinical characteristics the most common symptoms were Edema 31(77.5%) and Foamy urine 31(77.5%) followed by oliguria 17(42.5%), hypertension 14(35%) finally fever and other symptoms 5(12.5%).The commonest lesions were Focal segmental glomerulosclerosis (32.2%), followed by minimal Change disease (20.0%) and membranous nephropathy (17.5%). Membranoproliferative glomerulonephritis, IgA nephropathy and was (5.0%). Among others histologic findings including secondary glomerulopathiesrenal amyloidosis and Lupus nephritis were (5.0%) each, inconclusive findings (10.0%) and undetermined due to excessive fibrosis (1%). Conclusion: Primary glomerulopathies in Tanzania occur more commonly among young age (≤ 40 years) .Female patients were common presented with glomerulonephritis syndrome, while secondary glomerulopathies were presented in both Gender. There is considerable heterogeneity in the histologic spectrum of glomerulopathies which is influenced by age and a gender factor, Focal segmental glomerulosclerosis was the leading cause of primary glomerulopathies in this study. Recommendation: We recommend that kidney biopsying should be part of routine evaluation for patients with glomerulonephritis syndrome in our setting before giving corticosteroid and other adjuvant therapy .The findings from this study underscore the need to start and maintain the Tanzania Kidney Biopsy Registry that will be a great resource for future research on the causes and prevention of kidney diseases in Tanzania.