Abstract: TH-PO133

Improvement of Clinical Outcomes in Kidney Diseases via the On-line Thai Glomerular Disease Registry: Membranous Nephropathy

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Tonsawan, Pantipa, Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
  • Sangkhamanon, Sakkarn, Khon Kaen University, Khon Kaen, Thailand
  • Cheunsuchon, Boonyarit, Siriraj hospital, Bangkok, Thailand
  • Pichaiwong, Warangkana, RAJAVITHI HOSPITAL, Bangkok, Thailand
  • Charoenpitakchai, Mongkon, Phramongkutklao Hospital and College of Medicine, Bangkok, Bangkok, Thailand
  • Satirapoj, Bancha, Phramongkutklao hospital, Bangkok, Thailand

Group or Team Name

  • Thai Glomerular Disease Collaborative Network (TGCN)
Background

The primary membranous nephropathy (MN) is the common cause of adult onset nephrotic syndrome. The Thai glomerular disease registry was established by Thai Glomerular Disease Collaborative Network (TGCN) to evaluate the prevalence, clinical features and outcomes in Thai glomerular disease patients. This study focused especially on MN.

Methods

We conducted a prospective cohort study in the adults with native kidney biopsy proven glomerular diseases between July 2014 and Mar 2017 from TGCN registry. The clinical features and laboratory parameters at the time of biopsy, pathologic findings, treatment regimens and clinical outcomes were monitored.

Results

MN was presented 111 (7.1%) of total 1,556 patients and 111 (15.5%) of total 742 patients with primary glomerular diseases. Mean age was 52.6+15 years. The clinical features of MN were identified; 86 % nephrotic syndrome, 46 % hypertension, 5.4 % acute kidney injury and 4.5% asymptomatic proteinuria. At the time of renal biopsy, median serum creatinine was 0.98 mg/dL (0.42-7.4), median urine protein creatinine ratio was 3.5 g/g.Cr (0.14-21.9), mean serum albumin was 2.5+0.7 g/dL, and median interstitial fibrosis was 5% (5-90). Median time to remission was 5.6 months. At 24 weeks of follow up, complete remission and partial remission were observed in 20.7% and 59%, respectively. The predicting factors for clinical remission were identified as young patients, low serum creatinine, high hemoglobin, and high serum albumin at time of kidney biopsy. After the multivariate analysis, high serum albumin and low serum creatinine were the independent factors for clinical remission. Doubling of serum creatinine was observed in only 1.6 % during this period.

Conclusion

This study suggested that the clinical course and outcomes of Thai MN were favorable with low incidence of end stage renal disease. Baseline serum albumin and renal function were significantly predict the renal remission.
Funding: Health Systems Research Institute, and Nephrology Society of Thailand support

Funding

  • Private Foundation Support