SUN-284 MINITHEATER: A VIABLE OPTION FOR INTERVENTIONAL NEPHROLOGY PRACTICE IN RESOURCE POOR SETTINGS

Abstract

Interventional Nephrology (IN) is a new and emerging subspecialty of Nephrology that mainly deals with: renal ultrasonography and ultrasound-guided renal biopsy, dialysis access creation and dialysis access related percutaneous endovascular procedures. The dependence on other specialists to perform these procedures often resulted in delays in renal patient treatment, hence the birth of IN. Unfortunately, cost prohibits the establishment of an ideal IN centre in resource poor settings. To establish a viable IN practice in resource poor settings using minitheater. A minitheater space, trained nephrologist, couch, light source, trolley, surgical instruments, biopsy set, ultrasound machine and skin cleaning agents. UNTH Interventional nephrology minitheater At the Renal Unit of University of Nigeria Teaching Hospital Enugu, Nigeria, we set up a minitheater and organized an International Society of Nephrology (ISN) Continuing Medical Education (CME) training programme for nephrologists and nephrology trainees in May 2019. Seventy- seven participants from 17 centers in 4 out of the 6 geopolitical zones in Nigeria were in attendance. During the pilot study, 2 arteriovenous fistulae, 6 tunneled right internal jugular vein catheter placements, 5 adult and 4 pediatric real- time ultrasound- guided kidney biopsies were performed in the minitheater by the nephrologists. There was no procedural complication. Following this training programme, 3 centers have set up and are utilizing minitheaters for IN. It is feasible to set up and run a viable IN programme in resource poor settings using a mnitheater. This removes reliance on surgeons and radiologists making the nephrologist independent and ensuring prompt care of renal patients.