Abstract: TH-PO810
Influence of Hospital Practices on Native Glomerular Pathologic Patterns: Insights from the Largest Kidney Biopsy Cohort in Thailand
Session Information
- Pathology and Lab Medicine - I
November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Pathology and Lab Medicine
- 1800 Pathology and Lab Medicine
Authors
- Kanjanabuch, Talerngsak, Chulalongkorn University Faculty of Medicine, Bangkok, Bangkok, Thailand
- Isaranuwatchai, Suramath, Chulabhorn Hospital, Bangkok, Thailand
- Thammathiwat, Theerachai, Naresuan University Faculty of Medicine, Phitsanulok, Thailand
- Boonpucknavig, Vijitr, Bangkok Hospital, Bangkok, Bangkok, Thailand
- Nopsopon, Tanawin, Chulalongkorn University Faculty of Medicine, Bangkok, Bangkok, Thailand
Background
We sought to explore the effects of kidney biopsy and glomerular pathologic patterns using the largest Thailand kidney biopsy registry.
Methods
Records of kidney biopsy registries from the Chulalongkorn University (one of the biggest university-based hospitals in Thailand) and the Kidney Center Bangkok Hospital (a center providing kidney pathologic diagnosis for all private and public hospitals in Thailand) between 2000 and 2014 were analyzed and classified into three groups: university practice (U), private practice (Pv), and public practice (Pb). Records from pediatric patients, kidney transplant recipients, repeated biopsies, and insufficient clinicopathologic diagnosis were excluded from the study. One-way ANOVA was conducted to compare continuous variables among hospital types while Chi-Squared test and Fisher’s exact test were used for categorical variables.
Results
Out of 6,995 native kidney biopsies, 5,007 were eligible for analysis from 62 provinces covered all regions of Thailand over 15 years. University hospitals performed the highest number of kidney biopsies, followed by public and private hospitals. The three most common indications across all practice groups were nephrotic syndrome (NS), systemic lupus erythematosus (SLE, e.g., suspected lupus nephritis, morphologic diagnosis before making treatment decisions), and asymptomatic urinary abnormalities. U had a significantly higher proportion of biopsies due to SLE than the others (Image 1). In contrast, Pv performed biopsies with more indication of asymptomatic urinary abnormalities and unknown CKD than the others. Lupus nephritis was the most common pathological finding in U and Pb groups, while the Pv group was IgA nephropathy corresponding to the indications for biopsy.
Conclusion
The prevalence of pathologic diagnosis patterns is correlated well with the biopsy indication. Our findings highlight the influence of hospital practices on kidney biopsy indications and glomerular diagnoses.