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 37 hospitals. We conducted a prospective cohort study in the adults’ native kidney biopsy proven glomerular diseases between July 2014 and Mar 2019. The clinical and laboratory parameters at the time of biopsy, pathologic findings, treatment regimens and clinical outcomes were recorded via on-line registry. This year, we interested in the secondary glomerular disease causing by hepatitis B, hepatitis C, and HIV including the rare and poor prognosis disease such as deposit disease. Results: We recruited 2,755 patients performed native kidney biopsy during Jul 1, 2014 to Mar, 2019. The adequate data for analysis were 2,132 cases. The average age, creatinine, albumin, and cholesterol were 44+16 years, 2.15+19 mg/dL, 2.9+1.2 g/dL, and 290+138 mg/dL in respectively. The median proteinuria was 3.68 (0.02-42.03) g/day. The renal pathological findings showed 34.5% of LN, 13% of IgAN, 11.4% of FSGS, 7.9% of membranous nephropathy (MN), and 7.4% of minimal change disease (MCD). In our data, we found HCV-ATN 2 cases and HCV-associated GN 37 from 1,871 cases performed HCV testing including diabetic nephropathy 9 (24.3%), MPGN 5 (13.5%), FSGS 5 (13.5%), MCD 3 (8.1%), IgA 3 (8.1%), ANCA 2 (5.4%), and MN 2 (5.4%). Regarding the rare Paraprotein-related kidney diseases, we found only 22 cases mostly with 18 amyloidosis, 3 light chain deposit disease, and 1 heavy chain deposit disease. Conclusion: Our study described the common renal pathological findings including LN, IgAN, FSGS, MCD, and MN. we have performed the recommendation for management in glomerular disease, FSGS and MCD in adult Thai patients 2018 and IgA, MN 2019 in this report.
