Point-of-Care Ultrasound for Native Kidney Biopsies.

Abstract

Percutaneous kidney biopsy is a key procedure in the diagnosis and management of kidney disease but is being performed by nephrologists with decreasing frequency (1). Although it is a required component of subspecialty training in nephrology, exposure of trainees is often minimal. This results in fewer faculty with this skill, thereby accelerating this decline. The underlying reasons are manifold but stem in part from unfamiliarity with ultrasonography and availability of equipment. Consequently, biopsies are increasingly being performed in radiology departments, often under computed tomography guidance that results in unnecessary radiation exposure and cost because ultrasound guidance is sufficient in most patients (2,3). When performed by nephrologists, the biopsy is usually guided by a sonographer or radiologist, which complicates scheduling and is an inefficient use of manpower. With point-of-care sonography now widely available and increasingly being taught during medical school and residency, guidance of biopsies should no longer be an obstacle for nephrologists. Comprehensive training in sonography has been a component of the nephrology program at this institution for the past 25 years and has included guidance of percutaneous kidney biopsies. Over two decades ago, we reported a small series showing favorable success and complication rates for biopsies guided and performed entirely by nephrology faculty and trainees (4). We now report our experience with a much larger series of biopsies performed over a 22-year period. ### Patients This was a retrospective study in which a database of all kidney ultrasounds performed by the nephrology service at Emory University Hospital was searched for native kidney biopsies from July 1996 to September 2018. In addition to sonographic data, this database also contains information on the success rates. Additional information, including complications, was obtained on all biopsies since 2008 through review of the medical records. The study was approved by the Institutional Review Board …