C.O. Okani1, U.E. Ekrikpo2, C.A. Okolo3, Asinobi A.O.,4 BL Salako5 and E.E.U. Akang1
- Department of Histopathology, Benue State University, Makurdi, Benue State, Nigeria.
- Department of Medicine, University of Uyo Teaching Hospital, Uyo, Akwa Ibom State, Nigeria.
- Department of Pathology, University College Hospital, Ibadan, Oyo State, Nigeria.
- Department of Paediatrics, University College Hospital, Ibadan, Oyo State, Nigeria.
- Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
Abstract
Background: Renal biopsy remains the means by which definitive parenchymal kidney disease diagnoses are made. With the renal biopsy, the activity, progression and prognosis of renal parenchymal diseases can be studied with objectivity. We investigated the trend of renal histopathology request in a tertiary hospital in Nigeria over 31 years.
Objective: To determine the trend of renal biopsy requests in one of the biggest tertiary hospitals in Nigeria over a 31-year period (1981- 2011).
Methods: We retrospectively analysed all the renal biopsies submitted to the Department of Pathology, University College Hospital (UCH) Ibadan, South-West Nigeria over a 30 year period (1981-2011). Trend of requests of all the biopsies submitted from the Surgery, Paediatrics and Medicine departments was analysed using a test for linear trend. Gender and age groups trends were also studied.
Results: A significant reduction in the rates of renal biopsy request over the 31 year period (p=0.001) was noted which is attributed to diminution in requests from the Medicine and Paediatrics Departments (p<0.001), while the rates of requests from Surgery Department remain fairly uniform over this period (p=0.05). Decrease in biopsy requests significantly cuts across the ages in both genders.
Conclusion: Lack of adequately trained manpower, poor health insurance scheme and lack of facilities may be contributory in renal biopsy requests decline. Adequate efforts should be made towards reviving this important investigative modality in Nigerian tertiary hospitals.
Keywords: Kidney, Biopsy, Histology, Trend test, UCH Ibadan.
Correspondence:
Dr. Chukwudi O. Okani
Department of Histopathology,
Benue State University,
Markurdi,
Benue State.
E-mail: chudiokani@yahoo.com
Introduction
Obtaining a trucut renal biopsy and subjecting it to thorough histological studies (which includes: basic Haematoxylin & Eosin staining technique, histochemical, immunofluorescence, immunohisto chemical) and ultra-structural studies has been the bedrock for achieving definitive diagnoses and management of many kidney diseases worldwide1. The processes involved in obtaining reliable reports involve a multidisciplinary approach with a maximum involvement of all the highly trained and skilled personnel. The nephrologists, ultrasonographers, pathologists and technologists in the laboratory must be adequately trained if reliable and optimal patient management is desired by any institution. In a centre with a recordable high incidence of renal disease, it is expected that the rate of renal biopsy requests should approximate the number of patient with the diseases presenting to the hospital. It is therefore worrisome to note that in Nigeria and other African countries, despite reports on rising incidences of kidney diseases2-6, there seems to be steeply steady decline in kidney biopsies in the region. In order to quantify this assertion, we retrospectively investigated the trend of renal histopathology requests at Pathology Department, UCH, Ibadan.
MATERIALS AND METHODS
All the renal biopsies (including nephrectomies and trucut biopsies) submitted to the Department of Pathology of the UCH, Ibadan, South-West Nigeria and documented in the Surgical Day-Book over a 31- year period (January 1981 to December 2011) were analysed. Using trend test, we studied the trend of histopathology requests from the Medicine, Paediatrics and Surgical Departments. We also analysed the differences in trend by gender.