title: Spectrum of nephrotic syndrome in adults: clinicopathological study from a single center in India.
abstract: BACKGROUND
  The etiology of nephrotic syndrome (NS) in adults varies depending on the geographical location and is poorly studied in the Indian subcontinent.
  
  
  METHODS
  Patients (≥16 years old) with NS presenting to our center and undergoing a kidney biopsy from April 2010 to September 2012 were included for this study. All biopsies were subjected to light and immunofluorescence microscopy, and electron microscopy in selected cases. The histopathological spectrum was analyzed according to the various clinical parameters.
  
  
  RESULTS
  A total of 410 kidney biopsies were included for analysis. Two hundred and thirty seven (57.8%) patients were male and 173 (42.19%) patients were female. The average age at presentation was 33.68 ± 13.88 years. Among the patients, 88.05% (n = 361) were diagnosed with primary glomerular diseases (PGD) and 11.95% (n = 49) with secondary glomerular diseases (SGD). The most common histological lesions were focal segmental glomerulosclerosis (FSGS) (24.63%) followed by minimal change disease (MCD) (23.9%) and membranous nephropathy (MN) (22.44%). The most common form of SGD was lupus nephritis (LN) (6.58% of all cases). FSGS (28.27%) and MCD (21.96%) were the most common lesions in males and females, respectively. In the age groups of 16-29 years, 30-59 years, and ≥60 years, MCD (28.96%), MN (24%), and MN (40.74%) were the most common lesions, respectively, followed by FSGS in all groups (25.68%, 24.5%, and 18.52%, respectively). Among the patients, 27.07% had serum creatinine ≥1.5 mg/dL and 28.54% had either macroscopic or microscopic hematuria.
  
  
  CONCLUSIONS
  FSGS is increasingly becoming the most common cause of adult NS. This trend in Asia is seen predominantly in countries of the Indian subcontinent.
authors: Department of Nephrology, Institute of Postgraduate Medical Education & Research, Kolkata, West Bengal, India. drvgolay@gmail.com
authors: Vishal
authors: V
authors: Golay
authors: Mayuri
authors: M
authors: Trivedi
authors: Anila Abraham
authors: AA
authors: Kurien
authors: Dipankar
authors: D
authors: Sarkar
authors: Arpita
authors: A
authors: Roychowdhary
authors: Rajendra
authors: R
authors: Pandey
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000175:diagnosis* / Q000209:etiology* / Q000473:pathology; D012189:Retrospective Studies