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Abstract: TH-PO007

Conducting an Ultrasound Guided Kidney Biopsy Workshop in Leon, Nicaragua

Session Information

  • Educational Research
    November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 900 Educational Research

Authors

  • Mandayam, Sreedhar A., The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
  • Workeneh, Biruh, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
  • Mikhailov, Alexei V., Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States
  • Carstens, Michael H., Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, United States
Background

Investigations into the etiology of CKDu are hampered by very limited renal pathology specimens from patients due to multiple constraints like lack of training of nephrologists in bedside ultrasound guided renal biopsy, lack of renal pathologists. We describe our experience on conducting an Ultrasound Guided Renal Biopsy Workshop at the Hospital Escuela Oscar Danilo Rosales Argüello, Leon, Nicaragua

Methods

Nephrologists at Hospital Escuela Oscar Danilo Rosales Argüello, Leon and Hospital Espana Chinandega, participated. Patients provided informed consent. Local and Ministry of Health, Nicaragua (MINSA) IRB approval was obtained. 2 nephrologists from MD Anderson Cancer Center with experience performing ultrasound guided renal biopsies conducted the workshop. Phillips Lumify Ultrasound Transducers, Samsung S 6 tablets used scanning and CIVCO brackets used to act as needle guides. Scout scan to ensure 2 kidneys of normal size, lower pole of the kidney identified, depth of cortex measured, CIVICO bracket-needle guide system used to direct the angle of needle placement and depth of needle

Results

All biopsies were conducted in the operating room at the hospital. Conscious sedation provided in addition to local anesthesia. CBC and BMP measured 24 hours prior to biopsy.18 kidney biopsies were performed over 2 days. Initial 2 biopsies performed by faculty and the remaining 16 biopsies by the local doctors with the guidance from the faculty. 3 subjects were not biopsied (kidney size less than 8 cm and 1 uncontrolled HTN). 3 cores were obtained on all the 18 subjects. All cores deemed adequate by bedside cytopathologist. Post biopsy ultrasound scans performed on all 18 subjects showed no significant post biopsy bleeding. All patients had labs drawn at 24 hours and evaluation by nephrologist as safety follow up. None of the 18 subjects had clinically significant bleeding and no complications were noted at 24 hours post biopsy. All attendees affirmed a significant increase in comfort level about performing ultrasound guided renal biopsies and multiple renal biopsies have been performed independently subsequently

Conclusion

Ultrasound guided percutaneous renal biopsy can be performed safely in resource limited settings in Leon Nicaragua and the training workshop has significantly increased the ability of local nephrologists to perform renal biopsies