Abstract: FR-OR101
The Need for Nephropathology Teaching Worldwide: The ISN-Clinical Nephropathology Course Survey
Session Information
- Shaping the Future of Nephrology Education
October 26, 2018 | Location: 6F, San Diego Convention Center
Abstract Time: 05:42 PM - 05:54 PM
Category: Educational Research
- 800 Educational Research
Authors
- Bijol, Vanesa, Zucker School of Medicine at Hofstra/Northwell, Great Neck, New York, United States
- Jhaveri, Kenar D., Zucker School of Medicine at Hofstra Northwell, Great Neck, New York, United States
Background
The epidemiology and pathology of kidney disease is still unknown in large parts of the world that are burdened with high rates of CKD, in part due to inability to adequately process and interpret kidney biopsies. Clinical Nephropathology Certificate (CNC) Program is a joined educational initiative of the International Society of Nephrology (ISN) and American Nephrologists of Indian Origin (ANIO) primarily focusing on needs of nephrologists and pathologists in parts of the world with suboptimal nephropathology training and service. The CNC program(started 2013) includes over 40 recorded online lectures and 12 live webinars run by a pathologist and a nephrologist (one each month) made available over a one-year period.
Methods
We surveyed previous and current participants of the ISN CNC program to better understand the worldwide nephropathology practices. This voluntary survey was emailed to participants with 12 questions regarding the nephropathology service in their institutions and respective countries.
Results
The survey response was received from 293 out of 494 current or former participants (response rate 59%) from 63 countries. The data were evaluated using ISN regions and world bank economy classification. Results are summarized in Table below.
Conclusion
The survey responses suggest a large gap between the nephropathology practices in well-developed countries and the rest of the world. Even when existent in L/LM/UMIC, EM services are available for select cases and not routinely. The lack of trained nephropathologists and inability to adequately process samples is a common problem for the most of Africa, Asia, and Latin America, leading to underutilization of kidney biopsy procedures for diagnostic purposes. The lack of financial resources in these countries is still a significant limiting factor in establishing functional nephropathology laboratories. Programs like ours help bridge the education gap that exists in these countries.
Survey results stratified by world bank classification with regards to nephropathology services available in respondents’ countries and institutions where they practice
| WHO Nation types | n (%) | Electron microscopy in respondents’ countries | Nephropathology in respondents' institutions |
| Low income(LI) | 14 (5%) - 5 countries | None | No renal lab - 50%; LM only 36%; LM and IF 12%; EM 0% |
| Lower middle income(LMI) | 172 (59%) - 20 countries | Available in rare labs in 7 out of 20 countries, but not routinely | No renal lab - 23%; LM only 23%; LM and IF 36%; EM 18% |
| Upper middle income(UMI) | 36 (12%) - 12 countries | Exists in all countries but not routinely performed | No renal lab -20%; LM only 11%; LM and IF 23%; EM 46% |
| High income(HI) | 71 (24%) - 26 countries | Commonly present and used routinely in labs in 23 out of 26 countries | No renal lab - 23%; LM only 1%; LM and IF 35%; EM 41% |