Renal Changes in Burn Related Fatalities- An Autopsy based Prospective Histopathological Study from Tertiary Care Centre

Background: The intricate pathophysiological response along with burn induced kidney damage in Burn Injury needs to be better understood with a pathological study of the patient’s organs, which not only can shed light on disease progression and associated morbidity & mortality but also guide us in treatment response. Methods: A unicentric, prospective cross-sectional study was carried out in the Department of Pathology in collaboration with department of Forensics & State Medicine, Burdwan. Autopsy samples of both kidneys of Burn Injury (n=42) were processed, stained with H & E and reported by two Pathologist. Statistical evaluation was done in percentage, mean±standard deviation, Chi-square test and Fisher’s exact test. Results: Maximum number of study population belonged to 21-40 years age group ( 76.19% ). Most of them were females (85.71%), married (71.43%), Hindu by religion (73.81%) and belonged to rural population (80.95%). On Microscopic examination, 80.95% of study population had severe tubular necrosis amongst which only 45.24% survived for <72 hours. Severity of tubular necrosis is negatively correlated with duration of survival which was statistically significant. Desquamation of tubular epithelium and tubular cast formation (n=14, 33.33% ) showed statistically significant correlations with increasing burn severity (>90%TBSA) and negative correlation with duration of survival. Chronic interstitial inflammation (n=19, 45.23%) was found to be positively correlated with duration of survival with P-value of 0.0001. Conclusion: Burn-induced kidney damage restricts renal blood supply, causing epithelial degeneration and necrosis, with tubular cast formation and desquamation of tubular epithelium being significant indicators of injury severity and potential early mortality. Comprehending the complex interplay between burn severity, survival time, and kidney changes at different levels is vital, necessitating further investigation into the relationship between burn extent, survival duration, and subsequent renal alterations.