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Kidney Week

Abstract: SA-PO939

Comparative Efficacy and Safety of Kidney Biopsies Performed by Nephrologists vs. Interventional Radiologists: A Study in Two Level III Hospitals in Lima, Peru

Session Information

Category: Pathology and Lab Medicine

  • 1800 Pathology and Lab Medicine

Authors

  • Chimoy, Hemily Zandybell, Hospital Nacional Alberto Sabogal Sologuren, Callao, Lima, Peru
  • Lluncor, Juan Oscar, Hospital Nacional Dos de Mayo, Lima, Lima, Peru
Background

Renal biopsy is an invasive procedure. Formerly, this procedure was exclusive to nephrologists, but currently it is also performed by interventional radiologists. An adequate sample is crucial for the diagnosis, prognosis and treatment of the renal disease. Also, it is important to avoid associated complications.

Methods

All renal biopsies was performed from January to December 2023 in two level III hospitals in Lima, Peru. In the first hospital, renal biopsies were performed exclusively by interventional radiologists without the involvement of nephrologists, while in the second hospital, they were performed by nephrologists (real-time ultrasound guidance or marking point). Quality of the sample was evaluated according to the number of glomeruli reported in the analysis. Pre-biopsy laboratory variables, post-biopsy hemoglobin control, post-renal biopsy events and/or complications were compared as safety variables of the procedure.

Results

A total of 93 renal biopsies were reported during this period (47 renal biopsies performed by interventional radiologists and 46 by nephrologists). The efficacy of the procedure was evaluated by the quality of the sample. The mean number of glomeruli in the first group was 22, and in the second group, it was 18, with no significant difference found between the two groups (p = 0.343). No relationship was found between the number of reported glomeruli and any variables such as age, urea, creatinine, pre-procedure hemoglobin, longitudinal diameter, and kidney parenchyma, except for the anteroposterior diameter of the kidney (p = 0.03). In terms of safety, a significant difference was found for the presence of post-procedure pain (p < 0.01) and renal hematoma (p = 0.048) in the group of renal biopsies performed by interventional radiologists. There was also no significant difference in the variation of pre- and post-procedure hemoglobin levels in both groups.

Conclusion

This study demonstrated that the nephrologist-performed biopsies are equally effective and often safer than those performed by radiologists. Considering that the nephrologist is the one who has the initial contact with the patient and provides follow-up for the underlying condition throughout the treatment, it is important not to lose procedural skills for the benefit of our patients.