Abstract
Background: End stage renal disease (ESRD) affects the quality of life and causes the high cost in health care system. The prevention of ESRD is the early recognition and appropriate treatment. Glomerulonephritis is the third most common cause of ESRD in Thailand. Thai Glomerular Disease Collaborative Network (TGCN) was established to evaluate the epidemiology and clinical outcomes in the glomerular diseases and helped to promote the good system to taking care of these patients. Methods: TGCN originally consists of 9 tertiary care centers and expands to 20 hospitals. We conducted a prospective cohort study in the adults’ native kidney biopsy proven glomerular diseases between July 2014 and Mar 2017. The clinical and laboratory parameters at the time of biopsy, pathologic findings, treatment regimens and clinical outcomes were recorded via on-line registry. Results: We recruited 1,556 patients performed native kidney biopsy during Jul 1, 2014 to Mar, 2017. The female to male ratio was 1.88:1. The average age, creatinine, albumin, and cholesterol were 43.4+16 years, 2.11+19 mg/dL, 2.9+0.8 g/dL, and 294+131 mg/dL in respectively. The median proteinuria was 3.7 (0.02-25.3) g/day. The patients presented with 40% of nephrotic syndrome, 21.7% of nephritis, 19.4% of nephrotic nephritis, and 60.8% of renal impairment (creatinine>1.2 mg/dL). The renal pathological findings showed 33.9% of LN, 13.5% of IgAN, 10.5% of FSGS, 7.4% of minimal change disease(MCD), and 7.1% of membranous nephropathy (MN). The mean age of LN, IgAN, FSGS, MCD, and MN were 34.9, 39.4, 47.7, 46.5 and 52.6 years. The median creatinine at biopsy of LN, IgAN, FSGS, MCD, and MN were 1.08, 1.76, 1.65, 1.02 and 0.98 mg/dL. Conclusion: Our study described the common renal pathological findings including LN, IgAN, FSGS, MCD, and MN. The clinical outcomes and prognosis of these diseases were described in the complete report. In the second year, we have performed the recommendation for management in glomerular disease, FSGS and MCD in adult Thai patients.
