Background

Renal lesions are frequently encountered during autopsy examinations and may remain clinically silent during life. Histopathological evaluation of autopsy kidneys provides valuable insights into the spectrum of renal diseases and their association with systemic disorders. The present study aimed to evaluate the gamut of renal lesions identified in autopsy kidneys over a five-year period.

Methods

This retrospective cross-sectional study was conducted in the Department of Pathology of a tertiary care teaching hospital over five years. A total of 167 autopsy cases with adequately preserved kidneys were included. Gross and microscopic examinations of renal tissue were performed using routine hematoxylin and eosin staining along with special stains wherever required. Histopathological lesions were categorized into glomerular, tubular, interstitial, vascular, infective, and neoplastic lesions. Data were analyzed using SPSS version 25.0, and associations were assessed using Chi-square test with p<0.05 considered statistically significant.

Results

The mean age of the study population was 46.8 ± 15.7 years, with male predominance (67.1%). Hypertension (34.7%) and diabetes mellitus (24.6%) were the most common comorbidities. Grossly, congested kidneys (42.5%) were the predominant finding. Histopathologically, acute tubular necrosis was the most common lesion (32.3%), followed by benign nephrosclerosis (25.7%), diabetic nephropathy (17.4%), and chronic pyelonephritis (14.4%). Significant associations were observed between nephrosclerosis and hypertension, and between diabetic nephropathy and diabetes mellitus (p<0.001). Clinically silent renal lesions were identified in 37.1% of autopsies.

Conclusion

Autopsy kidneys demonstrate a broad spectrum of renal lesions, many of which remain undiagnosed during life. Acute tubular necrosis, nephrosclerosis, and diabetic nephropathy were the predominant histopathological findings. Autopsy-based renal histopathology remains an important tool for identifying occult renal disease, understanding clinicopathological correlations, and assessing the burden of nephropathies in the population.