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 core | 4.7 (0.6) | 4.7 (0.5) | 0.74 |
| Perform extra pass to obtain a research core | 2.3 (1.3) | 3.3 (1.2) | 0.02 |
| AKI with clinical equipoise | |||
| Suspected AIN from nafcillin vs. ATN from hypotension | 2.6 (1.2) | 3.6 (1.1) | 0.006 |
| Suspected CIN vs. atheroemboli post cardiac catheterization | 2.6 (1.2) | 3.2 (1.0) | 0.09 |
| Suspected ATN vs. AIN post cardiac surgery | 2.8 (1.3) | 3.4 (1.0) | 0.07 |
| AKI without clinical equipoise | |||
| Clinical diagnosis of AIN from nafcillin | 2.1 (0.9) | 3.1 (1.2) | 0.007 |
| Suspected CIN post cardiac catheterization | 2.1 (1.0) | 2.6 (1.1) | 0.18 |
| Suspected ATN post cardiac surgery | 1.9 (0.9) | 2.6 (1.2) | 0.09 |
| CKD | |||
| Non-proteinuric CKD stage 3 | 2.4 (1.0) | 3.2 (1.2) | 0.04 |
| CKD stage 3 suspected to be due to diabetes | 2.3 (1.2) | 3.3 (1.2) | 0.01 |
| Average score | 2.6 (0.9) | 3.3 (0.8) | 0.008 |
Funding
- Other NIH Support