Specimen Adequacy and Safety of Percutaneous Ultrasound-Guided Native Kidney Biopsies Performed by Short-Term Trained Nephrology Fellows

Hwang, Hyeon Seok; Lee, So Young; Kang, Seok Hui; Jung, Byung Ha; Hyoung, Bok Jin; Jeon, Youn Joo; Choi, Bum Soon; Park, Cheol Whee; Yang, Chul Woo; Kim, Yongsoo

Abstract

PURPOSE
Specimen adequacy and safety of percutaneous ultrasound-guided native kidney biopsies performed by short-term trained nephrology fellows were evaluated.
METHODS
The differences in specimen adequacy and safety between nephrology fellow-performed (NP, n=67) and radiologist-performed (RP, n=82) percutaneous ultrasound-guided native kidney biopsies were retrospectively evaluated.
RESULTS
The mean age of the patients was 35+/-15 years old, and the M:F ratio was 1.2:1. There were no differences in age, sex, anemia, platelet count and glomerular filtration rate between NP and RP patients. The mean glomerular count was 15.9+/-8.4 in light microscopy and 9.9+/-7.2 in immunofluorescent microscopy. Ninety five percent of biopsy specimens were adequate for pathological diagnosis. Between NP and RP kidney biopsies, there were no differences in the glomerular count in light and immunofluorescent microscopy, percentage of presence of glomeruli in electron microscopy, and the specimen adequacy for the pathological diagnosis. The rates of major and minor complications were 1.5% and 6%, respectively, in NP kidney biopsies. On the other hand, the rate of major complications was 9.8% in RP kidney biopsies, which was significantly higher than that in NP kidney biopsies. The rate of decrease in hemoglobin and hematocrit levels after biopsies was significantly higher in RP biopsies than in NP biopsies.
CONCLUSION
Short-term trained nephrology fellows perform percutaneous ultrasound-guided kidney biopsy at a level equal to or superior to radiologists.