HISTOPATHOLOGIC PATTERNS OF NEPHROTIC SYNDROME - A COMPARATIVE ANALYSIS IN PEDIATRIC AND ADULT POPULATION FROM A TERTIARY CARE CENTRE IN CENTRAL TRAVANCORE

This was a retrospective cross-sectional study done to understand the spectrum of histopathological patterns of nephrotic syndrome in both adult and pediatric population. We analyzed renal biopsies from 171 patients with nephrotic syndrome at a tertiary care center over five years (2019-2023). The study included patients with nephrotic-range proteinuria (urine albumin >3.5g/day or urine protein-creatinine ratio >3.5). The mean age of the study population was found to be 44.88 ± 17.63 years, with 60.8% males and 39.2% females. Primary nephrotic syndrome constituted 17.5% of cases, while secondary nephrotic syndrome comprised the majority of the cases (82.5%). Among primary cases, membranous nephropathy (33.3%), minimal change disease (MCD) (23.3%), and focal segmental glomerulosclerosis (FSGS) (26.7%) were the predominant lesions. Secondary nephrotic syndrome was mainly attributed to diabetic glomerulosclerosis (33.3%), proliferative glomerulonephritis (27.7%) and IgA nephropathy (22.7%),. The study observed that primary nephrotic syndrome was more common in children as compared to adults in whom secondary causes predominated. Membranous nephropathy was exclusively seen in adults, while MCD and IgM nephropathy were more frequent in pediatric cases.This study provides valuable insights into the histopathological spectrum of nephrotic syndrome in South Kerala, highlighting the importance of renal biopsy as a diagnostic tool,non MCD causes of nephrotic syndrome in pediatric population especially IgM nephropathy and predominance of secondary causes in adults.