Renal Biopsy Findings In Patients With Unexplained Elevated Serum Creatinine In Assiut University Hospital
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Assiut University
- Enrollment
- 210
- Locations
- 1
- Primary Endpoint
- correlation between histopathological findings and serum creatinine in umol/l
Study Overview
Brief Summary
Patients presented with unexplained elevated serum creatinine including vast varieties of acute or chronic kidney disease. Renal biopsy may include acute and chronic interstitial nephritis, glomerulosclerosis and tubular atrophy, acute tubular necrosis, rapidly progressive glomerulonephritis, granulomatous glomerulonephritis, monoclonal gammopathy, myeloma kidney or thrombotic microangiopathy .
Renal biopsy definitely still plays the most vital and irreplaceable role in the investigations of cases with unexplained renal impairment. Despite a vastly variable biopsy results between patients, renal biopsy has helped in determining the best treatment and prognosis for the patients.
Detailed Description
Chronic kidney disease (CKD) can be considered to be present if a patient has a glomerular filtration rate (GFR) <60 mL/min or markers of structural kidney disease that have been present for >3 months. These include proteinuria, haematuria and radiological abnormalities.
CKD is an important global-health challenge. It is found in 10% of the global population. The age-standardized global prevalence of CKD stages 1-5 in adults aged 20 and older was 10.4% in men and 11.8% in women. The incidence of end-stage renal failure is increasing worldwide with an annual growth rate of 8%.
In 2010, the total number of renal replacement therapy (RRT) patients worldwide amounted to 2.6 million, whereas the number of patients needing this treatment was estimated to be between 4.9 and 9.7 million, with the largest gap between need and supply of RRT in low-income countries, particularly in Asia and Africa.
In 2013, Egypt was among the countries for which CKD was ranked in the top 10 for years of life lost (YLL, calculated by multiplying numbers of deaths by life expectancy at time of death in a reference population) due to premature death and disability-adjusted life years (DALYs) to reflect the degree of disability such as pain or functional limitations caused by each condition.
Early detection and treatment of CKD can be implemented at minimal cost and will reduce the burden of ESRD, improve outcomes of diabetes and cardiovascular disease (including hypertension), and substantially reduce morbidity and mortality from non communicable diseases (NCDs).
Study Design
- Study Type
- Observational
- Observational Model
- Case Only
- Time Perspective
- Cross Sectional
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Impaired renal function (serum creatinine> 115umol/l serum urea > 8 mmol/l)
- •Negative immunological markers i.e ANA, ANCA, cryoglobulin, and complement level.
Exclusion Criteria
- •Diabetic patients.
- •Hypertensive patients.
- •All causes of Acute kidney injury
- •Bleeding diathesis.
- •Known cases of primary or secondary glomerulonephritis.
- •Patients with a single functioning kidney
- •small sized kidneys
- •Multiple renal cysts and ADPKD.
- •Patients with asymmetrical kidney size.
- •Patient with active infections.
- •HBsAg, HCV and HIV positive patients.
- •Obstructive uropathy.
- •Patients with active malignancies e.g multiple myeloma
- •Renal transplant.
- •Refusal to do a biopsy
Outcomes
Primary Outcomes
correlation between histopathological findings and serum creatinine in umol/l
Time Frame: 3 years
histopathological patterns in term of glomerlular pathology, interstitial fibrosis, tubular injury and serum creatinine in umol /l
Secondary Outcomes
No secondary outcomes reported
Investigators
Radwa Ellisy
Principal investigator
Assiut University