Safety and adequacy of percutaneous kidney biopsy performed by nephrology trainees

被引:30
作者
Esposito, Vittoria [1 ]
Mazzon, Giulia [2 ]
Baiardi, Paola [3 ]
Torreggiani, Massimo [1 ]
Semeraro, Luca [1 ]
Catucci, Davide [1 ]
Colucci, Marco [2 ]
Mariotto, Alice [2 ]
Grosjean, Fabrizio [4 ]
Bovio, Giacomo [5 ]
Esposito, Ciro [2 ]
机构
[1] ICS Maugeri, Unit Nephrol & Dialysis, Via S Maugeri 10, I-27100 Pavia, Italy
[2] Univ Pavia, Unit Nephrol & Dialysis, ICS Maugeri, Via S Maugeri 10, I-27100 Pavia, Italy
[3] ICS Maugeri, Sci Dept, Pavia, Italy
[4] Policlin San Matteo, Unit Nephrol, Pavia, Italy
[5] ICS Maugeri, Unit Palliat Care, Pavia, Italy
来源
BMC NEPHROLOGY | 2018年 / 19卷
关键词
Kidney biopsy; Trainee; Complications; Risk factors; RENAL BIOPSY; BLEEDING COMPLICATIONS; NATIVE KIDNEYS;
D O I
10.1186/s12882-017-0796-y
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Background: Recently there has been a progressive loss of specialty related skills for nephrologists. Among the skills we find the kidney biopsy that has a central role in diagnosis of renal parenchymal disease. One of the causes might be the belief that the kidney biopsy should be performed only in larger Centers which can rely on the presence of a renal pathologist and on nephrologists with a large experience. This trend may increase in the short term procedural safety but may limit the chance of in training nephrologists to become confident with the technique. Methods: We evaluated renal biopsies performed from May 2002 to October 2016 in our Hospital, a mid-sized facility to determine whether the occurrence of complications would be comparable to those reported in literature and whether the increase in the number of biopsy performing physicians including nephrology fellows which took place since January 2012, after our Nephrology Unit became academic, would be associated to an increase of complications or a reduction of diagnostic power of renal biopsies. Three hundred thirty seven biopsies were evaluated. Patients underwent ultrasound guided percutaneous renal biopsy using a 14 G core needle loaded on a biopsy gun. Observation lasted for 24 h, we evaluated hemoglobin levels 6 and 24 h and kidney ultrasound 24 h after the biopsy. Results: Complications occurred in 18.7% of patients, of these only 1,2% were major complications. Complications were more common in female (28%) compared to male patients (14,8%) (p = 0.004). We found no correlation between diagnosis, kidney function and complication rates; hypertension was not associated to a higher risk in complications. The increase of biopsy performing personnel was not associated to an increase in complication rates (18,7% both pre and post 2012) or with an increase of major complications (1.2% vs 1,2%). Conclusions: Kidney biopsy can be safely performed in mid-sized hospitals. Safety and adequacy are guaranteed even if the procedure is performed by a larger number of less experienced nephrologists as long as under tutor supervision, thus kidney biopsy should become an integral part of a nephrology fellow training allowing more widespread diffusion of this technique.
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页数:7
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共 21 条
  • [1] Cameron JS, 1997, AM J NEPHROL, V17, P347
  • [2] Adequacy and Complication Rates with 14-vs. 16-gauge Automated Needles in Percutaneous Renal Biopsy of Native Kidneys
    Chunduri, Svetha
    Whittier, William L.
    Korbet, Stephen M.
    [J]. SEMINARS IN DIALYSIS, 2015, 28 (02) : E11 - E14
  • [3] Safety and tissue yield for percutaneous native kidney biopsy according to practitioner and ultrasound technique
    Chung, Sungjin
    Koh, Eun Sil
    Kim, Sung Jun
    Yoon, Hye Eun
    Park, Cheol Whee
    Chang, Yoon Sik
    Shin, Seok Joon
    [J]. BMC NEPHROLOGY, 2014, 15
  • [4] Achieving Procedural Competence during Nephrology Fellowship Training: Current Requirements and Educational Research
    Clark, Edward
    Barsuk, Jeffrey H.
    Karpinski, Jolanta
    McQuillan, Rory
    [J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2016, 11 (12): : 2244 - 2249
  • [5] Bleeding Complications of Native Kidney Biopsy: A Systematic Review and Meta-analysis
    Corapi, Kristin M.
    Chen, Joline L. T.
    Balk, Ethan M.
    Gordon, Craig E.
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2012, 60 (01) : 62 - 73
  • [6] Career interest and perceptions of nephrology: A repeated cross-sectional survey of internal medicine residents
    Daniels, Michael N.
    Maynard, Sharon
    Porter, Ivan
    Kincaid, Hope
    Jain, Deepika
    Aslam, Nabeel
    [J]. PLOS ONE, 2017, 12 (02):
  • [7] Impact of Ultrasound-Guided Kidney Biopsy Simulation on Trainee Confidence and Biopsy Outcomes
    Dawoud, Dalia
    Lyndon, Will
    Mrug, Sylvie
    Bissler, John J.
    Mrug, Michal
    [J]. AMERICAN JOURNAL OF NEPHROLOGY, 2012, 36 (06) : 570 - 574
  • [8] Risk factors for bleeding complications in percutaneous renal biopsy
    Eiro M.
    Katoh T.
    Watanabe T.
    [J]. Clinical and Experimental Nephrology, 2005, 9 (1) : 40 - 45
  • [9] The Native Kidney Biopsy: Update and Evidence for Best Practice
    Hogan, Jonathan J.
    Mocanu, Michaela
    Berns, Jeffrey S.
    [J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2016, 11 (02): : 354 - 362
  • [10] Percutaneous Renal Biopsy of Native Kidneys: A Single-Center Experience of 1,055 Biopsies
    Korbet, Stephen M.
    Volpini, Kaelin C.
    Whittier, William L.
    [J]. AMERICAN JOURNAL OF NEPHROLOGY, 2014, 39 (02) : 153 - 162