Abstract: SA-PO0968
Clinical and Histopathologic Characteristics of Medical Kidney Biopsies from Incarcerated Persons in the Southwestern United States
Session Information
- Diversity and Equity in Kidney Health
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Diversity and Equity in Kidney Health
- 900 Diversity and Equity in Kidney Health
Authors
- Lin, Mercury Y., Cedars-Sinai, Los Angeles, California, United States
- Hou, Jean, Cedars-Sinai, Los Angeles, California, United States
- Haas, Mark, Cedars-Sinai, Los Angeles, California, United States
- Yamashita, Michifumi, Cedars-Sinai, Los Angeles, California, United States
- Choung, Hae Yoon Grace, Cedars-Sinai, Los Angeles, California, United States
- Nast, Cynthia C., Cedars-Sinai, Los Angeles, California, United States
Background
The United States of America has the largest incarcerated population. Yet, little literature exisits in study of inmate kidney biopsies.
Methods
An IRB approved study retrospectively identified inmate kidney biopsies from 2009-2025. Demographics, clinical history and pathologic parameters were analyzed.
Results
117 kidney inmate biopsies (from 116 patients) were identified from 25 clinical sites primarily in the Southwestern US. All were native kidney biopsies. Patients had mean age of 46 (range 21-76). 114 were cis-male, 1 was cis-female and 1 was trans-female. Ethnicities were 40 Hispanic, 30 African-American, 9 White, 2 American Indian/Alaskan Native, 1 Asian-American and 34 unspecified. 64 had hypertension and 22 were diabetic. 41 had chronic viral infection [most common were HCV (in 30) and HIV (in 6)]. 17 had illicit substance use [most common were opioids (in 6) and methamphetamines (in 4)]. Only 2 had prior kidney biopsies (excluding 1 with rebiopsy due to inadequacy). Indications for biopsy include 91 with renal insufficiency (81 for AKI, 7 for CKD, 3 for acute-on-chronic renal failure), 85 with proteinuria (38 with nephrotic range proteinuria) and 39 with hematuria (5 with gross hematuria). Of biopsies, 104 were optimal (cortex present in LM, IF and EM specimens), 12 were suboptimal (absence of cortex in at least 1 specimen) and 1 was inadequate for evaluation. The primary diagnoses were 30 with FSGS (including 5 with "collapsing" FSGS), 21 with IgAN and 14 with diabetic nephropathy, 12 with arterial nephrosclerosis, 9 with membranous nephropathy (2 PLA2R+, 7 PLA2R-), 9 with ATN, 6 with acute interstitial nephritis, 6 with amyloidosis (4 AA amyloidosis, 2 AL amyloidosis), 5 with infection-related GN and 5 with lupus nephritis. For IF/TA, 34 showed minimal (<10%), 45 showed mild (10-25%), 35 showed moderate (26-50%), 9 showed severe (>50%) and 4 were undetermined.
Conclusion
The most common indication for inmate kidney biopsy was renal insufficiency, closely followed by proteinuria. Almost all inmates obtained their index biopsy while incarcerated and the most frequent diagnoses were FSGS, IgAN and diabetic nephropathy. Most biopsies showed minimal or mild IF/TA. There was a low biopsy inadequacy rate (<1%). Limitation of this study included nearly all cis-male cohort, no transplant biopsies and no clinical follow-up data.