TITLE:
Renal Involvement in Systemic Diseases: A 13-Year Retrospective Renal Biopsy Study in Sub-Saharan African Patients
AUTHORS:
Mansour Mbengue, Fatoumata Kaba, Chérif Mouhamed Moustapha Dial, Mame Adjaratou Mariama Gassama, Serigne Fall, Idrissa Sall, Cheikh Mouhamadou Fadilou Kitane, Niakhaleen Keita, Maria Faye, Ahmed Tall Lemrabott, El Hadji Fary Ka, Abdou Niang
KEYWORDS:
Systemic Lupus Erythematosus, Sub-Saharan Africa, Renal Biopsy
JOURNAL NAME:
Open Journal of Nephrology,
Vol.16 No.2,
April
3,
2026
ABSTRACT: Background: Renal involvement is a frequent and potentially severe complication of systemic diseases, particularly immune-mediated disorders. Renal biopsy remains the gold standard for diagnosing, classifying, and guiding the management of renal lesions associated with these conditions. Data from Sub-Saharan Africa remain limited. Objectives: To describe the clinical indications and histopathological spectrum of renal involvement in systemic diseases based on renal biopsy findings over a 13-year period in a tertiary referral center in Sub-Saharan Africa. Methods: We conducted a single-center retrospective observational study from January 2011 to December 2023 in a university hospital pathology center in Senegal. All patients with a known or suspected systemic disease who underwent a renal biopsy and had histologically confirmed renal involvement were included. Sociodemographic data, biopsy indications, and histopathological findings were analyzed descriptively. Results: A total of 263 patients were included, representing 7.95% of all renal biopsies performed during the study period. The mean age was 39.1 ± 12.6 years, with a female predominance (72%). Renal biopsy indications were mainly related to systemic lupus erythematosus (SLE) (65.39%), dominated by proteinuria and renal failure. In 43.34% of cases, the diagnosis of the systemic disease was established based on renal biopsy findings. Histopathologically, membranous glomerulopathy and lupus nephritis were the most frequent lesions, with a predominance of proliferative forms, particularly class IV (22.05%) and class III (11.02%). Other lesions included membranoproliferative glomerulonephritis, crescentic glomerulonephritis, amyloidosis, tubulointerstitial nephritis, and thrombotic microangiopathy. SLE was the most common underlying systemic disease (80.60%), followed by cryoglobulinemia and amyloidosis among non-autoimmune conditions. Conclusion: Renal involvement in systemic diseases exhibits a wide clinical and histological spectrum, largely dominated by lupus nephritis. Given the nonspecific clinical presentations, renal biopsy is essential for accurate diagnosis, prognostic assessment, and therapeutic decision-making. These findings highlight the importance of improving access to renal biopsy and conducting prospective studies in Sub-Saharan Africa.