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Kidney Week

Abstract: FR-PO057

Results and Economic Benefits of the Implementation of an Interventional Nephrology Program in a Third-Level Center in Mexico City

Session Information

  • Educational Research
    November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Educational Research

  • 1000 Educational Research

Authors

  • Cuellar-Gonzalez, Fernando A., Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Consuegra-Flores, Sebastian, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
  • Arvizu Hernández, Mauricio, Instituto Nacional de Ciencias Medicas y Nutricion Salvador Zubiran, Ciudad de Mexico, Ciudad de México, Mexico
Background

Diagnostic and Interventional Nephrology (DIN) is an area of great interest and growth, it has shown great operational utility in the departments. Since 2015, a DIN program has been started in our center, with an area of ultrasound equipment and procedures. It has shown significant benefits for patients and in the training of nephrology residentss, mainly in renal graft biopsies (RGB), vascular access (VAs) and kidney biopsies (KB).

Methods

A retrospective, observational and descriptive study. RGB procedures (January/2015-May/2023) and VAs (July/2017-May/2023) were included; RGBs are performed on an outpatient basis; VAs with USG guidance, without fluoroscopy, with local anesthesia.

Results

A total of 4,092 procedures were performed, 2,167 RGBs (52.9%); 931 (22.7%) VAs for HD and KB 994 (24.2%). The most frequent indication for RGB was by protocol 699 (32.2%) and the presence of DSAs 586, (27%); 2115 (97.6%) were successful, and there were 52 complications (2.3%), 8 (0.3%) serious. Of the VAs, 601 (64.5%) were non-tunneled catheters (NTC) and 327 (35.1%) tunneled catheters (TC); the most frequent indications were chronic HD 438 (47%) and uremic syndrome 161 (17%); there were 57 complications (6.1%), 1 death. The economic burden reduction (EBR) was US $318.83 for each RGB and a total of US $690,904 (in 8 years). The EBR of the NTC VAs was US $140.59 per procedure, and a total of US $84,494 and for each TC the savings were US $179 with a total of US $58,533 (in 7 years). The EBR of the KB was US $214.25 per procedure, and a total US $212,964. The EBR of all procedures was US $1,046,895.

Conclusion

The implementation of the NDI program has yielded significant cost reductions of at least US $1,046,895 while ensuring the safety and well-being of patients. Beyond its financial impact, the program has also had broader benefits, including the advancement of resident training and the establishment of a specialized diploma in interventional nephrology of comprehensive 6-month training program and university validity, equips aspiring interventional nephrologists with essential skills and knowledge, solidifying its value in the field of nephrology education and practice.