Etiologies of glomerular diseases in Thailand: a renal biopsy study of 506 cases.
BACKGROUND
The nationwide renal registry has not yet been organized in Thailand, and the literature contains no registry of renal pathologic finding across the Southeast Asian (SEA) countries in the modern era when electron microscopy (EM) is routinely available.


OBJECTIVE
The aim of the present study was to examine the prevalence of renal pathology in Thai population.


METHODS
The authors reviewed the case file and renal biopsy specimens of King Chulalongkorn University Hospital to identify all adult native renal biopsy specimens received from January 2001 to December 2004, investigating prevalence and clinical and histological data. Biopsy of renal graft and in cases of trauma and tumors the authors excluded. Most of the biopsy specimens obtained The authorsre analyzed using light microscopy (LM), immunofluorescense (IF), and EM. Final diagnosis was made for each patient based on clinicopathologic correlations.


RESULTS
A total of 506 native renal biopsies were processed during this period, 69.8% were female and 30.2% were male. Their age average was 37 +/- 14.2 (13-80) years. The most common indications for renal biopsy were nephrotic syndrome and SLE (36.8%, 34.5%, respectively), followed by asymptomatic hematuria/proteinuria in 10.9% of patients. Secondary glomerular diseases were dominant against primary diseases in all but elderly age group (>50 years), particularly LN. Among primary glomerular diseases, the prevalence of IgAN, focal segmental glomerulosclerosis, and membranous nephropathy were 31.0%, 24.9%, and 13.1%, respectively. The provisional clinical diagnosis was correct in three fourths (73.2%) of the SLE cases. Postbiopsy complications occurred in 3.3% (17/506). Gross hematuria was seen in 2.3% (12/506), and perinephric hemptoma in 0.79%. Three of them required blood transfusion but none of them died and required an invasive procedure for resolution. The major complications were 2 folds less than regular prevalence (0.6% compared to 1.3%).


CONCLUSIONS
Although the data was collected from single center where EM is routinely performed, the authors believe that IgAN is the commonest primary GN in SEA countries. The authors are looking forward to seeing the nationwide registry data in Thailand and other SEA countries.
Kanjanabuch
Talerngsak
T
Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand. golfnephro@hotmail.com
Kittikovit
Wipathe
W
Lewsuwan
Songkiat
S
Leelahavanichkul
Asada
A
Avihingsanon
Yingyos
Y
Praditpornsilpa
Kearkiat
K
Eiam-Ong
Somchai
S
Tungsanga
Kriang
K
Sitprija
Visith
V
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016021:Epidemiologic Studies; D005260:Female; D005921:Glomerulonephritis / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012042:Registries; D013785:Thailand / Q000453:epidemiology