Prevalence and histological types of kidney disease in autopsied persons at Kampala Capital City Authority Mortuary.

Abstract

Introduction: It is estimated globally that in 2016, 5-10 million people died from kidney dis-ease (KD) and about 1.7 million died from acute kidney injury. In sub Saharan Africa the prevalence of KD is quite high and is estimated to be 13.9%. In Uganda, a community survey also established a high prevalence of KD of 21.4% of which 12.7% were at stage 2 but asymptomatic. There has been no systematic study to establish cause and histological pattern of this high prevalence of KD as renal biopsies are not ideal for such a study in some of these asymptomatic cases. Therefore, histological evaluation of kidneys obtained at autopsy provides a golden opportunity to identify histological lesions. General Objective: The purpose of this study was to determine the prevalence of KD in autopsied persons at Kampala Capital City Authority (KCCA) mortuary and characterize the histological types of these KD. Methods: A cross sectional study was undertaken on all medical -legal cases that had com-plete autopsy examination following approval from School of Biomedical Sciences Research and Ethics Committee (SBSHD-REC). Demographic information was obtained from police form 48A. The kidneys were macroscop-ically assessed and their morphometric parameters obtained. Samples were obtained, fixed and prepared for histological evaluation. Data was entered on collection forms, displayed in graphs, tables and charts and STATA 16/MP was used for analysis. Results: A total of 264 kidneys were studied from 132 autopsies. The majority (58.3%) of the participants were from central Uganda. The mean age of participants was 40 ±16 years and 99 (75.0%) of the specimens (kidneys) were from male autopsies. A total of 178 bodies had kidney pathologies (67.4%), with higher prevalence in male than female (71.9% versus 28.1%) respectively. The commonest KD was chronic interstitial nephritis identified in 37.1% of all kidneys examined followed by hypertensive nephrosclerosis which was identified in 28.0% of all kidneys examined. Conclusions and Recommendations: The prevalence of kidney disease among autopsied persons at KCCA mortuary was higher in male than female in a ratio of 3:1. Chronic interstitial nephritis and hypertensive nephrosclerosis were the most frequent histological KD. We recommend screening of kidney disease especially for patients with hypertension and diabetes.