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A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists

Introduction: Renal biopsy is an integral part of clinical nephrology practice that helps in the diagnosis of various renal diseases. Across the globe, it is performed by nephrologists and/or surgeons under ultrasound guidance. Lately, this novel procedure has been performed more frequently by the i...

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Autores principales: Aggarwal, Sandeep, Siddiqui, Waqas J, Shahid, Nauman, Baynes, Jaime, Khattak, Muhammad W, Ahmed, Irfan, Soundararajan, Suganthi, Ahmed, Ziauddin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948096/
https://www.ncbi.nlm.nih.gov/pubmed/31938607
http://dx.doi.org/10.7759/cureus.6315
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author Aggarwal, Sandeep
Siddiqui, Waqas J
Shahid, Nauman
Baynes, Jaime
Khattak, Muhammad W
Ahmed, Irfan
Soundararajan, Suganthi
Ahmed, Ziauddin
author_facet Aggarwal, Sandeep
Siddiqui, Waqas J
Shahid, Nauman
Baynes, Jaime
Khattak, Muhammad W
Ahmed, Irfan
Soundararajan, Suganthi
Ahmed, Ziauddin
author_sort Aggarwal, Sandeep
collection PubMed
description Introduction: Renal biopsy is an integral part of clinical nephrology practice that helps in the diagnosis of various renal diseases. Across the globe, it is performed by nephrologists and/or surgeons under ultrasound guidance. Lately, this novel procedure has been performed more frequently by the interventional radiologist (IR) as compared to nephrologists and surgeons. Methods: We completed a retrospective review of 378 consecutive renal biopsies performed at our university hospital in the city center of Philadelphia, Pennsylvania, between September 2008 and June 2011 for various indications. Baseline characteristics were comparable except systolic blood pressure (SBP), prothrombin time (PT), and international normalized ratio (INR) which was higher. Hemoglobin was lower in patients who underwent biopsy by the IR compared to those who were biopsied by nephrologists and/or surgeons. Results: The primary outcome showed the average number of glomeruli obtained with each biopsy was significantly lower by nephrology or surgical teams, 9.09 ± 5.17 vs. 19.17 ± 11.11 obtained by the interventional radiology team, p-value <0.0001. The number of cores obtained with each biopsy was significantly lower by nephrologist or surgeon at the bedside, 1.57 ± 1.05 vs. 2.42 ± 1.26, p-value <0.0001. The average number of attempts to obtain one core was 2.00 ± 1.10 vs. 2.60 ± 1.17 by nephrologist and surgeon vs. IR, respectively, p-value <0.0001. Conclusion: Our study clearly shows the superior success of renal biopsy by the IR as compared to the nephrology and surgical teams. This calls for more robust training of nephrology fellows and surgery residents to obtain the renal biopsy to prevent the loss of this unique procedure skill by non-radiology clinicians.
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spelling pubmed-69480962020-01-14 A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists Aggarwal, Sandeep Siddiqui, Waqas J Shahid, Nauman Baynes, Jaime Khattak, Muhammad W Ahmed, Irfan Soundararajan, Suganthi Ahmed, Ziauddin Cureus Radiology Introduction: Renal biopsy is an integral part of clinical nephrology practice that helps in the diagnosis of various renal diseases. Across the globe, it is performed by nephrologists and/or surgeons under ultrasound guidance. Lately, this novel procedure has been performed more frequently by the interventional radiologist (IR) as compared to nephrologists and surgeons. Methods: We completed a retrospective review of 378 consecutive renal biopsies performed at our university hospital in the city center of Philadelphia, Pennsylvania, between September 2008 and June 2011 for various indications. Baseline characteristics were comparable except systolic blood pressure (SBP), prothrombin time (PT), and international normalized ratio (INR) which was higher. Hemoglobin was lower in patients who underwent biopsy by the IR compared to those who were biopsied by nephrologists and/or surgeons. Results: The primary outcome showed the average number of glomeruli obtained with each biopsy was significantly lower by nephrology or surgical teams, 9.09 ± 5.17 vs. 19.17 ± 11.11 obtained by the interventional radiology team, p-value <0.0001. The number of cores obtained with each biopsy was significantly lower by nephrologist or surgeon at the bedside, 1.57 ± 1.05 vs. 2.42 ± 1.26, p-value <0.0001. The average number of attempts to obtain one core was 2.00 ± 1.10 vs. 2.60 ± 1.17 by nephrologist and surgeon vs. IR, respectively, p-value <0.0001. Conclusion: Our study clearly shows the superior success of renal biopsy by the IR as compared to the nephrology and surgical teams. This calls for more robust training of nephrology fellows and surgery residents to obtain the renal biopsy to prevent the loss of this unique procedure skill by non-radiology clinicians. Cureus 2019-12-06 /pmc/articles/PMC6948096/ /pubmed/31938607 http://dx.doi.org/10.7759/cureus.6315 Text en Copyright © 2019, Aggarwal et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Radiology
Aggarwal, Sandeep
Siddiqui, Waqas J
Shahid, Nauman
Baynes, Jaime
Khattak, Muhammad W
Ahmed, Irfan
Soundararajan, Suganthi
Ahmed, Ziauddin
A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists
title A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists
title_full A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists
title_fullStr A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists
title_full_unstemmed A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists
title_short A Comparison between Kidney Allograft Biopsies Performed by Nephrologists and Surgeons Versus Interventional Radiologists
title_sort comparison between kidney allograft biopsies performed by nephrologists and surgeons versus interventional radiologists
topic Radiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6948096/
https://www.ncbi.nlm.nih.gov/pubmed/31938607
http://dx.doi.org/10.7759/cureus.6315
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