Abstract: FR-PO947

Performance of Diagnostic and Interventional Nephrology (DIN) in Spain

Session Information

  • Patient Safety
    November 03, 2017 | Location: Hall H, Morial Convention Center
    Abstract Time: 10:00 AM - 10:00 AM

Category: Patient Safety

  • 1501 Patient Safety

Authors

  • Sosa Barrios, Haridian, Hospital Ramon y Cajal, Madrid, Spain
  • Ibeas, Jose, None, LONDON, LoNDON, United Kingdom
  • Betriu, Angels, IRB LLEIDA, LLEIDA, Spain
  • Paraiso, Vicente, Hospital U del Henares, Coslada, Spain
  • Quiros, Pedro, Servicio Andaluz de Salud (Spain), El Puerto de Santa María, Spain
  • Roca-Tey, Ramon, Hospital De Mollet, Bancelona, Spain
  • Cornago, Jose Ignacio, Hospital Galdakao, Bilbao, Spain
  • Rivera, Maite, Hospital Ramon y Cajal, Madrid, Spain

Group or Team Name

  • GNDI
Background

Diagnostic and Interventional Nephrology (DIN) has gained drive in the last few years. Line insertion (whether ultrasound guided or not), renal biopsy (native and transplanted), renal ultrasound and peritoneal dialysis (PD) catheters or permanent dialysis lines insertion are vital to our specialty.
Some of these procedures are delegated in other specialties. In our view, nephrologists should resume DIN as risk-benefit balance is better assessed, providing complete care for patients and reducing waiting times.

Methods

An online survey was sent by email to all Spanish Renal Departments in June 2015. The survey could be completed by any consultant and only one response per centre was allowed. Questions are listed in table 1.
The survey was written, supervised and approved by the DIN Nefrology Group (GNDI, Spanish Society of Nephrology).

Results

Of 195 Nephrology Departments in Spain, 70 responded (35.8%). All centres had HD, 81.4% PD and 34.3% had a transplant program. 72.3% (52) had ultrasound equipment.
Regarding catheter placement, 77.1% insert temporary jugular ones and 92.8% femoral. 75.7% perform native renal biopsies, of which 35.8% (19) are real-time ultrasound guided by nephrologists in full. Graft kidney biopsies are done in 26 centres, of which 46.1% are done by nephrologists.
Tunnelled haemodialysis catheters are done in 38.5%, peritoneal catheter insertion in 25.7% and only 2 centres (2.8%) perform arteriovenous fistulae (AVF) angioplasty.
In terms of ultrasound imaging, 28.5% do native kidneys ultrasound and 22.8% grafts. 71.4% of all centres offer carotid ultrasound assessment to evaluate cardiovascular risk, only 21% done by nephrologists.
AVF's ultrasound scanning is done in 55.7% (39 centres).

Conclusion

DIN has spread in Spain, although there's still a long way ahead. It includes basic techniques to our specialty and allows more independency and efficiency.
Therefore, appropriate training on different techniques should be warranted to nephrologists, implementing programs to do so aiming to minimize complication rates.

Funding

  • Government Support - Non-U.S.