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Assessment of Urinary Sediments in the Diagnosis of Different Types of Primary Glomerulonephritis

Author(s): Alam MR, Islam MN, Jahan F, Ahammod T, Rahman AKMS

Background: Glomerulonephritis (GN) is one of the major causes of chronic kidney disease (CKD) throughout the world and is leading causes of end stage renal disease (ESRD). The cellular and acellular materials that are present in urine sample of GN patients have great clinical significance.

Objective: To assess urinary sediments in the diagnosis of different types of primary glomerulonephritis.

Methods: This study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. A total of 100 adult patients with primary glomerular disease were enrolled in this study and their renal biopsy was done. Fresh midstream urine (MSU) sample (10 ml) was obtained from each patient and was analyzed accordingly.

Results: Mean(±SD) age of the study subjects was 34.5±14.0 years. Of them; 60% were male and 40% were female, male to female ratio was 1.5:1. Among 100 study participants 32(32.0%) were non-proliferative glomerulonephritis and 68(68.0%) were proliferative glomerulonephritis. It was observed that, hypertension was more common in proliferative group than non-proliferative group. Urinalysis revealed that; most of the varieties of proliferative glomerulonephritis presented with 2+ protein in
urine, less than 10/HPF of white blood cell (WBC) in urine, more than 10/ HPF red blood cells (RBC) and granular cast in urine along with occasional very few red blood cell cast (RBC cast) in urine. Among total cases; 55% presented with nephrotic range proteinuria. Renal failure was present in 54% cases and more marked in proliferative glomerulonephritis.

Conclusion: Urinary sediments analysis along with other clinical and biochemical parameters can help us to distinguish proliferative types of glomerulonephritis, although particular variety of glomerulonephritis is difficult to confirm by urinalysis.

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