A Prospective Histopathological Study of Renal Changes in Cases of Flame Burns Brought to Government Medical College Mortuary, Kadapa, Andhra Pradesh

Abstract

Background: Burn injuries remain a major public health problem and are associated with significant morbidity and mortality worldwide. Acute kidney injury is one of the most important systemic complications following severe flame burns and contributes substantially to mortality. Histopathological examination of renal tissue provides valuable insights into the pathological alterations associated with burn injury and their relationship with survival duration.

Objectives: To identify the histopathological changes in kidneys among fatal flame burn cases and to correlate these findings with post-burn survival.

Materials and Methods: A prospective observational autopsy-based study was conducted in the Department of Forensic Medicine in collaboration with the Department of Pathology, Government Medical College, and Kadapa. Thirty consecutive flame burn fatalities fulfilling the inclusion criteria were enrolled. Following medico-legal autopsy, both kidneys were preserved in 10% neutral buffered formalin, processed routinely, and stained with hematoxylin and eosin for microscopic examination. Histopathological changes were recorded and analyzed using descriptive statistics.

Results: Thirty flame burn cases were included, comprising 15 males and 15 females with a mean age of 43.2 years. Congestion was the most frequent histopathological finding (73.3%), followed by cloudy degeneration (66.7%), acute tubular necrosis of proximal convoluted tubules (63.3%), distal tubular necrosis (46.7%), interstitial inflammatory infiltration (43.3%), tubular casts (20.0%), and pyelonephritis (6.7%). The majority of significant renal changes were observed in patients surviving between 4 and 7 days following burn injury.

Conclusion: Renal histopathological alterations are common following fatal flame burns. Congestion, cloudy degeneration, and acute tubular necrosis constitute the predominant pathological changes. Histopathological evaluation of kidneys provides valuable evidence regarding systemic burn injury and may aid in understanding mechanisms contributing to mortality.