Etiologies of Glomerular Diseases in Thailand: A Renal Biopsy Study of 506 Cases
Talerngsak Kanjanabuch, MD*, WipaThe authorse Kittikovit, MD **, Songkiat Lewsuwan, MD *, Asada Leelahavanichkul ,MD*, Yingyos Avihingsanon, MD*, Kearkiat Praditpornsilpa ,MD *, Somchai Eiam-Ong, MD *, Kriang Tungsanga, MD *, Visith Sitprija MD, PhD***
Affiliation : * Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital ** Department of Pathology, Faculty of Medicine, Chulalongkorn University Hospital *** Queen Saovabha Memorial Insitute, The Thai-Red Cross Society
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
Materials and Methods : The authors revieThe authorsd 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 authorsre 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 were31.0%, 24.9%, and 13.1%, respectively.
The provisional clinical diagnosis was correct in three fourths (73.2%) of the SLE cases. Postbiopsy compli-
cations occurred in 3.3% (17/506). Gross hematuria was seen in 2.3% (12/506), and perinephric hematoma
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%).
Conclusion : 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.
Keywords : Renal biopsy, Glomerular disease, Nephrotic syndrome
