Patterns of Biopsy-Proven Kidney Diseases at a Tertiary Care Center in Thailand, 2020–2023

Abstract

Introduction: Contemporary data on biopsy-proven kidney diseases in Thailand remain limited. We evaluated the pathological spectrum, clinical presentations, and age-related distribution of diseases identified by native kidney biopsy at a tertiary-care center. Methods: We retrospectively reviewed native kidney biopsy records at Phramongkutklao Hospital, Bangkok, from January 2020 to December 2023. After data auditing, 552 unique patients with one prespecified index biopsy were included. Pathological diagnoses and clinical presentations were analyzed as non-mutually exclusive categories. Age-related analyses were exploratory. Results: Lupus nephritis was the most frequently recorded diagnosis (165/552, 29.89%), followed by IgA nephropathy (128/552, 23.19%), diabetic nephropathy (64/552, 11.59%), membranous nephropathy (53/552, 9.60%), and focal segmental glomerulosclerosis (45/552, 8.15%). Nephrotic syndrome was the most common presentation (341/552, 61.78%), followed by nephritic syndrome (144/552, 26.09%). Nephrotic syndrome was particularly frequent in minimal change disease (100.0%), membranous nephropathy (92.5%), and membranoproliferative glomerulonephritis (92.3%). Age-related differences were observed for several diagnoses, including lower frequencies of IgA nephropathy and lupus nephritis and higher frequencies of membranous nephropathy and ANCA-associated vasculitis with increasing age (exploratory P≤0.002). Conclusions: This tertiary-care cohort demonstrated a heterogeneous spectrum of kidney diseases and clinical presentations. Lupus nephritis and IgA nephropathy were the most frequently recorded pathological diagnoses. Several diagnoses varied substantially by age, highlighting the importance of age and clinical presentation in interpreting kidney biopsy patterns.