Kidney Biopsy Epidemiology Project a Springboard For Future Research

Cleveland Clinic Florida Nephrologist Shane A. Bobart, MD, FASN, is leading a Kidney Biopsy Epidemiology Project to establish the spectrum and clinicopathological characteristics of kidney diseases seen and treated at Cleveland Clinic in the United States.

“This is the first retrospective review of kidney biopsy data at Cleveland Clinic with the goal of gaining epidemiological insights into renal disease,” says Dr. Bobart, who specializes in diabetic kidney disease and glomerular diseases, with a special interest in membranous nephropathy and IgA nephropathy.

Following the data

According to Dr. Bobart, the Kidney Biopsy Epidemiology Project captures nearly seven years of data retrospectively obtained from patients who had a native kidney biopsy performed or reviewed at Cleveland Clinic in Florida and Ohio from 2015 to 2021. He and a team of Ohio and Florida-based residents and nephrology fellows are combing through thousands of electronic medical records to compile demographic and clinical data that will be used to drive future research.

“Our nephrologists and nephropathologists across the Cleveland Clinic enterprise perform and review kidney biopsies on a daily basis,” says Dr. Bobart. “We have a wealth of data to be explored as we work to determine disease prevalence, identify disease-specific clinical characteristics, and track outcomes.”

After excluding transplant kidney biopsies, over 4,000 unique patients with native kidney biopsy data were identified by the research team. Preliminary results show the most common glomerular disease diagnoses across the enterprise were: focal segmental glomerulosclerosis (15.2%), diabetic kidney disease (14.6%), IgA nephropathy (7.7%), lupus nephritis (7.0%), ANCA vasculitis (6.6%), and membranous nephropathy (5.1%).

“Our data aggregation efforts have been aided by standardized record keeping and coding practices for renal disease put in place across the industry in recent years,” acknowledges Dr. Bobart. “It is much easier now to identify clear diagnoses through the EMR and with more uniform pathology biopsy reporting.”

Launching future research

Outside of chronic kidney disease and end-stage kidney disease, there is currently limited information on the incidence and distribution of biopsy-proven kidney disease in the United States. This can hamper research into new treatments, points out Dr. Bobart, who co-authored a chapter on Glomerular Clinicopathologic Syndromes in the newly published National Kidney Foundation’s Primer on Kidney Diseases, 8th Edition.

“Our goal is to identify which kidney diseases are most prevalent among our patient populations at Cleveland Clinic, so that we can pursue clinical trials that will ultimately benefit all patients with these conditions,” explains Dr. Bobart.

He also notes that Cleveland Clinic cares for diverse patient populations, especially in Florida, which is an important factor when conducting clinical research. For example, the population of Broward County, Florida, which is home to Cleveland Clinic Weston Hospital, is 30% African American, 31% Hispanic or Latino, and 35% white Caucasian/non-Hispanic.

“We know that African Americans and Hispanics are at greater risk for kidney failure, so it’s important for any research into renal disease to be as inclusive as possible,” he says.

Philanthropic support

Dr. Bobart is the recipient of a Caregiver Catalyst Grant, which provides Cleveland Clinic caregivers seed funding supported by philanthropy to try new ideas and prove new concepts and approaches to positively impact patient care. These one-time grants are awarded through a competitive process to the project proposals that show the most promise for making an impact within one year.

“I’m grateful to have the opportunity to pursue research that can help illuminate the presence of kidney disease in our communities and provide an avenue for seeking better treatments,” adds Dr. Bobart.