Abstract
BackgroundPercutaneous kidney biopsy is the gold standard investigation for the diagnosis of kidney diseases. The associated risks of the procedure depend on the skill and experience of the proceduralist as well as the characteristics of the patient. The Kidney Health Australia – Caring for Australasians with Renal Impairment (KHA-CARI) guidelines on kidney biopsies, published in 2019, are the only published national kidney biopsy guidelines. As such, this study surveys current kidney biopsy practices in Australasia and examines how they align with the Australian guidelines, as well as international biopsy practice.MethodsA cross-sectional, multiple-choice questionnaire was developed examining precautions prior to kidney biopsy; rationalisation of medications prior to kidney biopsy; technical aspects of kidney biopsy; complications of kidney biopsy; and indications for kidney biopsy. This was distributed to all members of the Australian and New Zealand Society of Nephrology (ANZSN).ResultsThe response rate for this survey is approximately 21.4 % (182/850). Respondents found agreement (> 75.0 %) in only six out of the twelve questions (50.0 %) which assessed their practice against the KHA-CARI guidelines.ConclusionsThis is the first study of its kind where kidney biopsy practices are examined against a clinical guideline. Furthermore, responses showed that practices were incongruent with guidelines and that there was a lack of consensus on many issues.
Highlights
Percutaneous kidney biopsy is the gold standard investigation for the diagnosis of kidney diseases
Our study demonstrates that there is significant variation among Australasian nephrologists surrounding the practice of kidney biopsy
Our study provides an overview of kidney biopsy practices in Australasia
Summary
Percutaneous kidney biopsy is the gold standard investigation for the diagnosis of kidney diseases. Percutaneous kidney biopsy is the gold standard investigation for the diagnosis of kidney parenchymal diseases, providing more information to guide decisions for management of kidney disease and discussion with patients regarding their prognosis [1]. In the context of kidney transplantation, a kidney biopsy is the gold standard for the Despite the clinical benefits, the procedure is not without risks. The major risks associated with kidney biopsies pertain to bleeding and its sequelae. The literature points to the fact that the kidney biopsy is a relatively safe procedure with 1.6 % of cases requiring a blood transfusion post-biopsy, and 0.3 % requiring angiographic or surgical intervention (nephrectomy) [4].
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