Abstract Ref Number = APCP1090
HISTOPATHOLOGICAL PATTERNS IN PEDIATRIC KIDNEY DISEASE IN CIPTO MANGUNKUSUMO GENERAL HOSPITAL 2013-2017
Sudung O Pardede,Sharfina F Adilla,Partini P Trihono,Henny A Puspitasari,Eka L Hidayati,Cahyani Gita Ambarsari
Departement of Child Health Faculty of Medicine Universitas Indonesia Cipto Mangunkusumo General Hospital
Background : Kidney biopsy is a diagnostic tool to support clinician’s judgement in pediatric kidney disease diagnosis. Histopathological findings which come along after kidney biopsy gives additional value to clinical findings. Thorough knowledge of both not only is providing information useful for management but also predicting prognosis. There is a wide variation in histopathological pattern of kidney disease worldwide according to race, genetic predisposition, age group, social economy, geographic region and biopsy policy in each institution. Registry is needed to describe the histological pattern of pediatric kidney diseases in Indonesia, especially Cipto Mangunkusumo General Hospital (CMH).
Material : A-descriptive retrospective study was conducted in CMH during January 2013 to 2017. Secondary data from medical record was obtained. Children with various kidney disease who underwent kidney biopsy and met the inclusion and exclusion criteria, were included in the study. All biopsies were studied by pathologic anatomy department under light microscopy and immunofluorescence. Demographic data, clinical diagnosis, and histophatological findings were extracted and analyzed.
Results : Eight sample was excluded because the data was inadequate, and 109 samples were considered for analysis. Out of 109 patients, 91% were above 5 years with female predominance (63%). The commonest indication for biopsy were nephritis lupus (39%) followed by resistant steroid nephrotic syndrome/RSNS (34%), and glomerulonephritis (11%). Half of nephritis lupus patients undergone biopsy was classified to class IV based on histological findings. Patients with RSNS showed focal segmental glomerulosclerosis (FSGS), minimal change disease (MCD) and mesangioproliferative GN patterns (30%,19%,7% consecutively). One patient with previously diagnosis lupus nephritis displayed anti GBM glomerulonephritis. All Henoch-Schonlein nephritis patients undergone kidney biopsy revealed IgA nephropathy as the histological finding.
Conclusions : Resistant steroid nephrotic syndrome and lupus nephritis were two most common indication for kidney biopsy. Histological findings predominating RSNS patients was FSGS while lupus nephritis was class IV. This study is consistent with existing literature.
Keywords: kidney biopsy histopathological pattern pediatric kidney disease