Histopathological patterns in kidney biopsies in Zimbabwe: a 12-year retrospective study

Objectives:  Data on histological patterns in native kidney biopsies in Zimbabwe is sparse. We sought to describe these histological patterns over a 12 year period. Study Design:  We retrospectively evaluated the histological patterns on kidney biopsies at the largest private pathology laboratory in Zimbabwe from 1 January 2008 to 31 January 2020. Setting: Histopathological data on all percutaneous native kidney biopsy specimens received at the pathology lab was recovered from electronic records. Indications for the kidney biopsy were then reviewed and patient demographics collected. Subjects:  All patients who had a histopathological report identified from the electronic records and who had had a kidney biopsy for nephrological indications were included. Results:  Sixty four 64 reports in total were identified and 18 were excluded (17biopsies done to evaluate renal masses and 1 kidney transplant biopsy). Thus 46 percutaneous native kidney biopsies were evaluated in the final analysis. Ninety six percent of the patients biopsied were of African descent. Primary FSGS was the commonest primary glomerular disease (26%) and lupus nephritis the commonest secondary glomerular disease (24%). The commonest indication for kidney biopsy was nephrotic syndrome (61%). Conclusions:  FSGS was the commonest primary GN in this study of adult patients and the commonest indication for kidney biopsy was nephrotic syndrome. This finding is useful for guiding clinicians on managing patients presenting with nephrotic syndrome in low resource settings as often patients lack access to kidney biopsy services and empiric use of steroids may be considered in appropriate individual cases.