Abstract: TH-PO122
Primary Nephrologist Procedural Status Impact on Kidney Biopsy Findings
Session Information
- Clinical/Diagnostic Renal Pathology and Lab Medicine - I
November 02, 2017 | Location: Hall H, Morial Convention Center
Abstract Time: 10:00 AM - 10:00 AM
Category: Glomerular
- 1004 Clinical/Diagnostic Renal Pathology and Lab Medicine
Authors
- McFadden, Christopher B., Cooper Medical School of Rowan University, Camden, New Jersey, United States
- Hunter, Krystal, Cooper Medical School of Rowan University, Camden, New Jersey, United States
- Naik, Manjula J-S, Clinical renal Associates, Phoenixville, Pennsylvania, United States
Background
A kidney biopsy is an important diagnostic procedure in the field of Nephrology. It generally yields information regarding multiple components of a patient's kidney problems including the diagnosis, therapeutic options, and prognosis. The decision to perform a kidney biopsy represents a balance of relevant risks and benefits by the provider (typically nephrologist) and patient. Frequently, the decision to perform a biopsy is guided most by the the likelihood the findings will alter patient care.
Methods
We performed a retropsective study of 99 native kidney biopsies perfromed within the last 10 years at our institution. Our primary hypothesis was the status of the primary nephrologist (performs biopsy or does not perform biopsy) had a signficant impact on the kidney biopsy findings as assessed by whether immune based therapy was used in the next 3 months after time of kidney biopsy (yes or no). A chi square test was used to compare the outcome (immune therapy or not) in the two referring nephrology groups. The study was reviewed and approved by the Cooper University Hospital IRB.
Results
A significantly higher rate of immune therapy (65.9 vs 29.3%, p <0.01) was noted in the group whose primary nephrologist performed biopsies (3 nephrologists) compared to the group whose primary nephrologist did not perform biopsies (6 nephrologists). The groups were similar in terms of their age, serum creatinine, and urine protein to creatinine ratio as presented in Table 1. The patient characteristics reported represent data from 30 and 46 subjects, respectively, in the biopsy/ non biopsy groups.
Conclusion
This retropepctive chart review suggests the status of the primary nephrologist (performing biopsy or not performing a biopsy) impacts which patients get a kidney biopsy. These potential biases should be considered as the decision to perform a biopsy is made. This study is limited by its single center design, retrospective nature, and lack of information about patient outcomes.
Nephologist Procedural Status Impacting Bx. Findings
| Nephologist performs Bx | Nephrologist does not perform Bx. | |||
| Biopsy Led to Immune Therapy | 27/41 (65.9%) | 17/58 (29.3%) | ||
| Patient Characteristics | ||||
| Age (years) | 52.2 | 56.1 | ||
| Serum Creatinine (mg/dl) | 1.88 | 1.75 | ||
| Urine protein/creatinine | 4.4 | 5.1 |