CLINICAL AUDIT OF HISTOLOGY BASED RENAL DISEASES IN DARLING DOWNS HEALTH REGION

V KHELGI1, 2, S VENUTHURAPALLI1, 2, S GOVINDARAJULU1, A LEE1, A GUPTA1, 2,

1Renal service, Darling Downs Hospital and Health Service, Toowoomba, Queensland; 2Rural School of Medicine, University of Queensland, Toowoomba, Queensland

Aim: To retrospectively analyse the prevalence of various types of kidney diseases at Darling Downs Hospital and Health service (DDHHS) based on renal biopsy findings in adults during the last 10 years (2006 to 2016).

Background: DDHHS caters to a wide and diverse geographic area (90,000 sq km) with population more than 300,000 belonging mainly to farming community. All the kidney biopsies are performed under radiologic guidance and specimens were analysed at Royal Brisbane Hospital.

Methods: Relevant data including the demographics, laboratory data and biopsy findings were collected from the charts. The histological diagnosis was classified into 5 categories namely glomerular, tubulo-interstitial, vascular, myeloma related and normal/unclassified. Glomerular diseases are further classified into primary and secondary glomerular.

Results: 216 biopsies were performed at our hospital in the last 10 years.  After excluding normal/unclassified samples (n=23), 193 samples were further analysed. Glomerular diseases was the predominant pathology (n=140, 72%).Primary glomerular diseases is the most common indication (n=120, 62 %) and among these, IgA nephropathy (n=31, 16%) and ANCA associated GN (n=31, 16%)) represent the majority of cases followed by membranous (n=19) and FSGS (n=12). Diabetic nephropathy accounted only for 3% and is consistent with selection bias for renal biopsy. There were 13% of patients with acute or chronic Tubulointerstitial nephritis.

Conclusions: This audit reflected primary glomerular disease as the most commonly biopsied renal disease. ANCA associated GN were as common as IgA nephropathy and prevalence is higher in our region as compared to other series in Australia and New Zealand. Further studies are suggested to investigate the regional variation in ANCA associated GN.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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