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Abstract: FR-OR101

The Need for Nephropathology Teaching Worldwide: The ISN-Clinical Nephropathology Course Survey

Session Information

Category: Educational Research

  • 800 Educational Research


  • 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

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.


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.


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.


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 typesn (%)Electron microscopy in respondents’ countriesNephropathology in respondents' institutions
Low income(LI)14 (5%) - 5 countriesNoneNo renal lab - 50%; LM only 36%; LM and IF 12%; EM 0%
Lower middle income(LMI)172 (59%) - 20 countriesAvailable in rare labs in 7 out of 20 countries, but not routinelyNo renal lab - 23%; LM only 23%; LM and IF 36%; EM 18%
Upper middle income(UMI)36 (12%) - 12 countriesExists in all countries but not routinely performedNo renal lab -20%; LM only 11%; LM and IF 23%; EM 46%
High income(HI)71 (24%) - 26 countriesCommonly 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%