Exploring hospital practice types and their impact on glomerular pathologic patterns: Insights from the largest kidney biopsy cohort in Thailand
Issued Date
2023-08-01
Resource Type
eISSN
14401797
Scopus ID
2-s2.0-85166419251
Pubmed ID
37534843
Journal Title
Nephrology (Carlton, Vic.)
Volume
28
Start Page
24
End Page
34
Rights Holder(s)
SCOPUS
Bibliographic Citation
Nephrology (Carlton, Vic.) Vol.28 (2023) , 24-34
Suggested Citation
Kanjanabuch T., Isaranuwatchai S., Nopsopon T., Thammathiwat T., Pooprasert T., Puapatanakul P., Pongpirul K., Chawanasuntorapoj R., Kittiskulnam P., Eiam-Ong S., Tungsanga K., Chusil S., Ophascharoensuk V., Vanichakarn S., Sitprija V., Boonpucknavig V. Exploring hospital practice types and their impact on glomerular pathologic patterns: Insights from the largest kidney biopsy cohort in Thailand. Nephrology (Carlton, Vic.) Vol.28 (2023) , 24-34. 34. doi:10.1111/nep.14202 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88287
Title
Exploring hospital practice types and their impact on glomerular pathologic patterns: Insights from the largest kidney biopsy cohort in Thailand
Author's Affiliation
Siriraj Hospital
Harvard T.H. Chan School of Public Health
Faculty of Medicine, Chiang Mai University
Thai Red Cross Agency
Bangkok Hospital Medical Center
Naresuan University
Chulabhorn Royal Academy
University of Liverpool
Johns Hopkins Bloomberg School of Public Health
Faculty of Medicine, Chulalongkorn University
The Kidney Foundation of Thailand
Uttaradit Hospital
Harvard T.H. Chan School of Public Health
Faculty of Medicine, Chiang Mai University
Thai Red Cross Agency
Bangkok Hospital Medical Center
Naresuan University
Chulabhorn Royal Academy
University of Liverpool
Johns Hopkins Bloomberg School of Public Health
Faculty of Medicine, Chulalongkorn University
The Kidney Foundation of Thailand
Uttaradit Hospital
Other Contributor(s)
Abstract
BACKGROUND: This study aims to investigate the influence of different kidney biopsy practices on the prevalence of glomerular pathologic patterns in the largest kidney biopsy registry in Thailand. METHODS: We conducted a retrospective review of kidney biopsy records from the period between 2000 and 2014. The records were obtained from 2 major institutions: King Chulalongkorn Memorial Hospital, a large university-based hospital, and the Kidney Center Bangkok Hospital, which provides pathology services to hospitals throughout Thailand. The study included native kidney biopsies from all provinces in Thailand, excluding paediatric patients, kidney transplant recipients, and cases of inadequate and repeated biopsies. Patient demographics, indications for biopsy, and final glomerular diagnoses were compared across different hospital practice settings: university (UVH), private (PVH) and public (PBH). RESULTS: A total of 5893 eligible native kidney biopsies were identified from a pool of 7005 biopsies conducted over a 15-year period in 25 provinces throughout Thailand. The 3 most common indications for biopsy were suspected kidney involvement in systemic lupus erythematosus (SLE) (29%), nephrotic syndrome (NS) (29%), and acute glomerulonephritis (AGN)/rapidly progressive glomerulonephritis (RPGN) (13%). The leading indication for biopsy differed across practice types, with suspected kidney involvement in SLE being the primary indication in UVH, while NS took precedence in both PBH and PVH practices. Notably, UVH performed fewer kidney biopsies for asymptomatic urinary abnormalities and diabetes-related indications compared with PVH and PBH. The leading glomerular diagnoses correlated with the biopsy indications, with lupus nephritis (LN) being the most common diagnosis in UVH and PBH practices, whiles immunoglobulin A nephropathy was the predominant diagnosis in PVH practice. CONCLUSION: Hospital practice types significantly impact the prevalence of glomerular pathologic diagnosis patterns in kidney biopsy data, highlighting the importance of considering this influence in epidemiological comparisons.