Kidney Week

Abstract: FR-PO322

Experience of a Tertiary Center in the Training of Nephrology Fellows on Performing Real-Time Ultrasound-Guided Percutaneous Kidney Biopsy

Session Information

• CKD: Clinical, Outcomes, Trials - II
  November 08, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2102 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Santa Catharina, Guilherme P., University of Sao Paulo (USP), Sao Paulo, Brazil

Guilherme P. Santa Catharina,

• Smolentzov, Igor, University of Sao Paulo (USP), Sao Paulo, Brazil

Igor Smolentzov,

• Neves, Precil D., University of Sao Paulo (USP), Sao Paulo, Brazil

Precil D. Neves,

• Dias, Cristiane B., University of Sao Paulo (USP), Sao Paulo, Brazil

Cristiane B. Dias,

• Yu, Luis, University of Sao Paulo (USP), Sao Paulo, Brazil

Luis Yu,

• Woronik, Viktoria, University of Sao Paulo (USP), Sao Paulo, Brazil

Viktoria Woronik,

• Zatz, Roberto, University of Sao Paulo (USP), Sao Paulo, Brazil

Roberto Zatz,

• Jorge, Lectícia, University of Sao Paulo (USP), Sao Paulo, Brazil

Lectícia Jorge,

Background

Percutaneous kidney biopsy is a fundamental diagnostic tool in Clinical Nephrology, but there is concern as to whether it can be performed by Fellows. The aims of this study were to report a 10-year experience of a tertiary academic center in the qualification of Fellows to perform ultrasound-guided percutaneous biopsies of native kidneys.

Methods

This is a retrospective cohort study of native kidney biopsies performed between January/2009 and December/2018. The procedures were performed by Fellows and supervised by experienced Nephrologists. Predictors of complications, clinical outcomes and sample quality were analyzed.

Results

A total of 1387 biopsies was performed; the mean age was 40.7±16.2 years, with 60% of women (n=830) and the Body Mass Index was 25.2 kg/m². At the time of biopsy, lab exams were: serum Creatinine 2.2 ± 1.9 mg/dL, BUN 31±16 mg/dL, Hemoglobin 11.7±1.8 g/dL and Platelet count 262±95x10³/mm³. As to complications, 91.4% (n=1268) had none, 4.5% (n=63) had hematuria; 2% (n=28) had symptomatic hematoma; 2% (n=28) had majorcomplications, defined by the need for transfusion and/or arteriography. Independent predictors of major complications were female gender (OR 2.9; CI 1.01 to 8.1; p=0.049), hemodialysis (OR 8.0; CI 2.9 to 9.2; p<0.001), low platelet count (OR 0.99; CI 0.98 to 0.99; p=0.035) and hemoglobin level (OR 0.61; CI 0.40 to 0.96; p=0.032). The average sample contained18±10 glomeruli for light microscopy, 11±8 for immunofluorescence, while and 90% of samples contained at least 8 glomeruli.

Conclusion

Supervised kidney biopsies performed by Fellows in training were safe and efficient. Female gender, hemodialysis, low platelet count and hemoglobin levels were independent predictors for major complications.