Evaluation of Chronic Kidney Disease in Sudden Death Cases – A One Year Autopsy Study in Tertiary Care Hospital

Authors

  • S Mondal Associate Professor,Department of Pathology, Rampurhat Govt. Medical College.
  • R Pradhan Demonstrator,Department of Pathology, College of Medicine and Sagore Dutta Hospital.
  • S Chatterjee Assistant Professor,Department of Pathology, Rampurhat Govt. Medical College.
  • S Biswas Assistant Professor, Department of Forensic Medicine and Toxicology, Rampurhat Govt. Medical College.
  • M Sikder Assistant Professor,Department of Pathology, RG Kar Medical College.

DOI:

https://doi.org/10.48165/

Keywords:

Chronic kidney disease, Medicolegal autopsy, Renal biopsy, Sudden death

Abstract

Autopsy is the ultimate diagnostic test, typically the gold standard with an assumed 100% sensitivity for establishing the causes of death.  Medicolegal autopsies are conducted in cases of sudden, suspicious and unnatural deaths. The frequency and spectrum of renal  pathologies on medicolegal autopsy specimens are not well documented in the literature. Our study aimed at diseases in sudden death cases  based on the histomorphological findings by microscopical examination of renal tissue. Kidney specimens of 120 Medicolegal autopsy  cases were received, processed and examined in our department over a period of 2 years. Out of 120 cases chronic kidney cases (CKD) was  identified in 45 ( 37.5%) cases. In our study 28 cases were male (62.22%) and 17 cases were female (37.78%). The different lesions  suggesting CKD were, glomerulosclerosis 2 cases (4.44%), Chronic pyelonephritis in 6 (13.33%) cases, Vascular sclerosis 32 cases  (71.11%) and in 5 cases (11.11%) interstitial nephritis. This study analyzed various entities of chronic kidney disease found in medicolegal  autopsies. These entities either contribute or directly responsible for the death of the individuals. 

References

Sulegaon R, Kulkarni D, Chulki S. Medicolegal autopsies interesting and incidental findings. Int J Forensic Sci Pathol. 2015;3(8):156–60.

Goldman L. Autopsy 2018: Still Necessary, Circulation. 2018; 137:2686–2688. http://circ.ahajournals.org DOI: 10.1161/ CIRCULATIONAHA.118.033236

Henriksen KJ. Autopsy Kidneys: An overlooked resource. autops case rep. 2018;8. doi:10.4322/acr.2018.013

"What Is Chronic Kidney Disease?". National Institute of diabetes and digestive and kidney diseases. June 2017. Retrieved 19 December 2017.

Jha V, Garcia-Garcia G, Iseki K, et al. Chronic kidney disease: global dimension and perspectives. Lancet. 2013;382(9888):260-72. http://dx.doi.org/10.1016/S0140- 6736(13)60687-X. PMid:23727169

Khare P, Gupta R, Agarwal S, et al. [August 10, 2021]. Spectrum of renal lesions on autopsy: Experience of a tertiary level institute based on retrospective histopathological analysis. Cureus 13(8): e17064. DOI

7759/cureus.17064

Yadav SNS, Bhattacharya AB. Histo morphological study of kidney lesions in autopsy - an original eight year study. IOSR J Dent Med Sci. 2019;18(5):50–4.

Patel S, Rajalakshmi BR, Manjunath GV. Histopathologic findings in autopsies with emphasis on interesting and incidental findings – a pathologist's perspective. J Clin Diagn Res. 2016;10(11):8–12.

Siegel J. Encyclopedia of Forensic Sciences. Academic Press 2000; 303-308.

Xu J, Murphy SL, Kochanek KD, Arias E. Mortality in the United States, 2015. NCHS Data Brief. 2016;(267):1-8. PMid:27930283.

Imai E, Horio M, Watanabe T, Iseki K,Yamagata K, Hara S. Prevalence of chronic kidney disease in the Japanese general population. Clin Exp Nephrol. 2009;13:621-630.

Hall YN, Hsu CY, Iribarren C Darbiman J, Mc Culloch CE, Go Alan S. The conundrum of increased burden of end stage

ISSN : 0971 - 0973, e - ISSN : 0974 - 0848

renal disease in Asians. Kidney Int. 2005;68:2310-2316.

Nagata M, Ninomiya T, Doi Y, Yonemolo K, Kubo M, Hata J. Trends in the prevalence of chronic kidney disease and its risk factors in a general population : the Hisayama Study. Nephrol Dial Transplant. 2010;25:2557-2564.

Whaley-Connell AT, Sowers JR et al. CKD in the United States: kidney early evaluation program (KEEP) and national health and nutrition examination survey (NHANES) 1999-2004. Am J Kidney Dis. 2008; 51: 13–20.

Vassalotti JAet al. Screening populations at increased risk of CKD: the KEEPand the public health problem. Am J Kidney Dis. 2009; 53:107-114.

Go AS, Chertow GM, Fan D, et al. Chronic kidney disease and the risks of death, cardiovascular events and hospitalization. N Engl J Med. 2004;351:1296–1305.

Neha S, Devi THM, Pukhrambam GD, Haricharan A. Pathological findings in kidney in medicolegal autopsies: A study. Indian J Forensic Community Med. 2021;8(1):33-38.

Sandhu VK, Puri A, Singh N. The Histo morphological spectrum of renal lesions in an autopsy study. Ann Pathol Lab Med. 2017;4(4):A410–4. doi:10.21276/apalm.1455

Hailemariam S, Walder M, Burger HR, et al. Renal pathology and premortem clinical presentation of Caucasian patients with AIDS: An autopsy study from the era prior to antiretroviral therapy. Swiss Med. Wkly2001;131:412-17.

Usta U, Tastekin E, Isler E, Kutlu AK, Puyan FO. Histopathological and immune alterations in autopsied kidneys. Saudi Med J. 2014;35:1331-38.

Devi PM.,Myrthong BG.,Th Meera, Nabachandra H. (2013). Pathological findings of liver in autopsy cases a study at Imphal. Journal of Indian Academy of Forensic Medicine. 2013;35(3): 206-210.

Garg M, Aggarwal AD, Kataria SP. Coronary atherosclerosis and myocardial infarction an autopsy study. Journal of Indian Academy of Forensic Medicine. 2011;33(1):39-42.

Marshall HS, Milikowski C. Comparison of clinical diagnoses and autopsy findings: six-year retrospective study. Arch Pathol Lab Med.2017;141:1262–1266. doi: 10.5858/ arpa.2016-0488-OA

Shojania KG, Burton EC, McDonald KM, Goldman L. Changes in rates of autopsy-detected diagnostic errors over time : a systematic review. JAMA. 2003;289:2849–2856. doi: 10.1001/jama.289.21.2849

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Published

2023-12-05

How to Cite

Evaluation of Chronic Kidney Disease in Sudden Death Cases – A One Year Autopsy Study in Tertiary Care Hospital . (2023). Journal of Indian Academy of Forensic Medicine, 45(1), 41–44. https://doi.org/10.48165/