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Kidney Week

Abstract: TH-PO558

The Cleveland Clinic Kidney Biopsy Epidemiology Project

Session Information

  • Pathology and Lab Medicine
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Pathology and Lab Medicine

  • 1700 Pathology and Lab Medicine

Authors

  • Portalatin, Gilda Melissa, Cleveland Clinic Florida, Weston, Florida, United States
  • Sawaf, Hanny, Cleveland Clinic, Cleveland, Ohio, United States
  • Shettigar, Shruti, Cleveland Clinic Florida, Weston, Florida, United States
  • Carrión Rodríguez, Astrid I., Cleveland Clinic Florida, Weston, Florida, United States
  • Herlitz, Leal C., Cleveland Clinic, Cleveland, Ohio, United States
  • Gebreselassie, Surafel K., Cleveland Clinic Florida, Weston, Florida, United States
  • Bobart, Shane A., Cleveland Clinic Florida, Weston, Florida, United States
Background

The kidney biopsy is the gold standard for diagnosing kidney disease. Large-scale, epidemiological studies describing the prevalence of biopsy proven kidney diseases are lacking. We aimed to determine the spectrum and prevalence of biopsy proven kidney disease across the Cleveland Clinic.

Methods

We identified all patients who had a native kidney biopsy performed/reviewed at the Cleveland Clinic from January 2015 to September 2021. Clinical and demographic characteristics were obtained by retrospective chart review. Results were stratified by age, race and state to assess any epidemiological trends in kidney disease.

Results

Over 9600 patients were identified. After excluding transplant/donor biopsies and unavailable records, we had 4148 patients with native biopsy data. The mean age at biopsy was 57 years old, with 46% female. There were 3256 patients in Ohio and 349 patients in Florida. Self-reported racial demographics were 72.9% white (5.1% Hispanic), 21.7% black, 3.1% multi-racial, and 1.6% Asian. Diagnoses identified were: FSGS (15.2%), diabetic kidney disease (DKD) (14.6%), IgA nephropathy (7.7%), lupus nephritis (7.0%), pauci-immune glomerulonephritis (6.6%), membranous nephropathy (5.1%), acute interstitial nephritis (AIN) (3.0%), and amyloidosis (2.7%).

When stratified by age groups 0-18, 19-64, 65-85 and over 85 years old, AIN and pauci-immune glomerulonephritis were more prevalent in those >85 years. Among those <65 years old, lupus nephritis, IgA nephropathy and minimal change disease was more prevalent. In Ohio, there was a higher percentage of black (23.4% vs 17%) and non-Hispanics (96.3% vs.79.2%) vs Florida with more white (74.8% vs 71.8%) and Hispanics (20.8% vs 3.7%). Pauci-immune glomerulonephritis was more commonly seen in whites, while DKD, FSGS and lupus nephritis were more prevalent in black patients. Notably, the prevalence of membranous nephropathy, a disease that primarily affects whites, was similar between white and black patients in our cohort (5.0 vs 5.2%).

Conclusion

Our study catalogues the spectrum of biopsy proven kidney disease across the US Cleveland Clinic enterprise. Key demographic and geographical trends have been identified. Future studies include an in depth look at clinical outcomes and clinic trails for specific glomerular diseases at our Florida and Ohio campuses.

Funding

  • Private Foundation Support