Dr Namrata Khanal1,3, Ms Natasha Woods1, Ms Cherie Follett1,2, Mr Edson Avisado1
1Mildura Base Public Hospital, MILDURA, AUSTRALIA, 2Royal Melbourne Hospital, Melbourne, Australia, 3School of Rural Health, Monash University, Mildura, Australia
Aim: To share the experience of setting up kidney biopsy program in a regional centre
Background: Kidney biopsy remains a gold standard investigation when it comes to establishing a histopathological diagnosis in a large category of kidney diseases. Historically, patients from Mildura who required native kidney biopsy had to travel >500 kilometers to Melbourne for the procedure.
Methods: This prospective study describes the steps of setting up successful kidney biopsy program and clinical parameters including post-biopsy complications.
Results: The process of setting up included: a) Planning – proposal of the procedure and credentialing of the Nephrologist b) Creating protocol and policy suitable for local health service in collaboration with all stakeholders involved c) Approval by the policy review committee d) Implementation and initiation of the procedure e) Regular in service education of the nursing staff involved in patient care f) auditing the service provided. Since April 2021 till date, 12 native and one transplant kidney biopsy were performed. Bard max core disposable kidney biopsy guns were used for sampling. All biopsy samples were performed under real-time ultrasound guidance with sonographers’ assistance. Eight of the biopsies were performed in the inpatient setting. Patients were admitted for investigations under general medical team and referred to nephrology for further investigation when a renal pathology was suspected. Two of the inpatients were for the management of anticoagulants and one resided >100 km away from the health service. One patient had haematuria, which improved following rest. One had hypotension not related to internal haemorrhage and one had hypertension which improved with anti-hypertensives post procedure.
Conclusion:
With good planning and policies, kidney biopsy can be safely performed in regional Australian setting.
Biography:
To come