Clinical and Anatomopathological Profile of Kidney Disease by Renal Biopsy at the Renaissance University Hospital Center in N’Djamena, Chad

Introduction: Kidney biopsy is the gold standard in the diagnosis and management of underlying parenchymal renal diseases. Information garnered from histologic examination of renal tissue is essential in studying the histological lesions affecting the kidney, in order to make a positive diagnosis and a better choice of treatment. However, renal biopsy is not within the reach of all african countries, in which least of all is in sub-Saharan Africa. The objective of this study is to determine the hospital prevalence, the indications for percutaneous renal biopsy and the clinical and histopathological profile of kidney disease.

Patients and Methods: We conducted a descriptive cross-sectional study focusing on PRB which was carried out between from August 1, 2020 to July 31, 2023 within the Nephrology and Hemodialysis Department of the Renaissance University Hospital Center, a tertiary referral hospital in N’Djamena, Chad. Included in the study were all children and adult patients who had undergone a renal biopsy and had no contraindications in undergoing the procedure. The variables studied were the hospital prevalence of kidney biopsy, epidemiological and clinical data and etiological of kidney disease, indications of PRB and histological results.

Results: During the study period, 1700 patients were hospitalized in the department. However, 22 patients were included in our study with a hospital prevalence of 1.29%. The median age was 25 years +/- 14.9 years with extremes ranging from 6 to 60 years. The sex ratio was 1.4. Nephrotic syndrome was the main indication in 68.2% (n=15) of cases, followed by isolated acute renal failure in 13.6% (n=3) of cases, chronic renal failure with extrarenal manifestations in 13.6% (n=3) of cases and rapidly progressive glomerulonephritis in 4.5% (n=1). Glomerular involvement was the most frequent in 86.4% (n=19) of cases, tubulo-interstitial involvement in 9.1% (n=2) of cases and renal vascular involvement in 4.5% (n=1). The most common histological lesions were focal segmental glomerular hyalinosis in 40.9% (n=9) of cases, lupus nephritis in 27.4% (n=6) of cases and extracapillary glomerulonephritis in 9.1% (n=2) of cases.

Conclusion: Renal histology has a very important place in the diagnosis, treatment and prognostic assessment of renal diseases. Focal segmental glomerular hyalinosis is the main histological lesion found in this series. The establishment of a registry of renal biopsy in our department would allow better knowledge and management of kidney pathologies in Chad.

Keywords: Kidney Biopsy, Nephrotic Syndrome, FSGS, Chad.