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Kidney Week

Abstract: SA-PO013

Exploring Nephrologists' Attitudes Towards Kidney Biopsies for Research

Session Information

  • Educational Research
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 800 Educational Research

Authors

  • Amodu, Afolarin Ayomide, Brigham and Women's/ Massachusetts General Hospital, Boston, Massachusetts, United States
  • McMahon, Gearoid M., Brigham and Women's Hospital, Brookline, Massachusetts, United States
  • Palsson, Ragnar, Harvard, Belmont, Massachusetts, United States
  • Sarvode Mothi, Suraj, Brigham and Women''s, Boston, Massachusetts, United States
  • Waikar, Sushrut S., Harvard Medical School, Boston, Massachusetts, United States
Background

Recent interest in kidney biopsies for research purposes raises the question of safety versus benefit of the procedure. Physician perspectives on indications for kidney biopsy and perceived safety of the procedure have not been studied in detail

Methods

We sent an IRB-approved, anonymous, online survey to 98 nephrologists at three Boston academic hospitals. Participants were asked about their clinical experience, their perception of the risk of kidney biopsies, and the likelihood that they would support biopsies being obtained from their patients for research purposes. We scored responses using a Likert Scale (1 = “absolutely not”; 5 = “definitely yes”). We compared scores using independent sample t-test

Results

Response rate was 58%. The Table shows mean scores according to whether nephrologists were primarily clinicians (n=12) or clinician-researchers (n=43). There were no differences between the respondents’ assessment of renal biopsy risk when comparing researchers vs. clinicians or stratifying by years of experience or number of biopsies performed. Overall, nephrologists who were primarily clinicians scored lower than researchers on the scale for willingness to allow research kidney biopsies

Conclusion

Substantial variability exists among nephrologists regarding the indications for kidney biopsy and their comfort with kidney biopsies for research purposes

Willingness of nephrologists to allow patients to be approached for research kidney biopsies. Results are reported as mean (SD) on a 1 through 5 scale (higher number suggests higher likelihood
 Primarily clinical care
(n=12)
Primarily research
(n=43)
p-value
Reserve a portion of an existing core4.7 (0.6)4.7 (0.5)0.74
Perform extra pass to obtain a research core2.3 (1.3)3.3 (1.2)0.02
AKI with clinical equipoise   
Suspected AIN from nafcillin vs. ATN from hypotension2.6 (1.2)3.6 (1.1)0.006
Suspected CIN vs. atheroemboli post cardiac catheterization2.6 (1.2)3.2 (1.0)0.09
Suspected ATN vs. AIN post cardiac surgery2.8 (1.3)3.4 (1.0)0.07
AKI without clinical equipoise   
Clinical diagnosis of AIN from nafcillin2.1 (0.9)3.1 (1.2)0.007
Suspected CIN post cardiac catheterization2.1 (1.0)2.6 (1.1)0.18
Suspected ATN post cardiac surgery1.9 (0.9)2.6 (1.2)0.09
CKD   
Non-proteinuric CKD stage 32.4 (1.0)3.2 (1.2)0.04
CKD stage 3 suspected to be due to diabetes2.3 (1.2)3.3 (1.2)0.01
Average score 2.6 (0.9)3.3 (0.8)0.008

Funding

  • Other NIH Support