CHANGES IN KIDNEY BIOPSY PRACTICE AND DIAGNOSES OVER THE COURSE OF THE COVID-19 PANDEMIC
Dr Rachel Brennan1, Dr Benjamin Strimaitis1, Dr Yilin Tian1, Dr Benjamin Adams2,3, Dr Robert Ellis1, Dr Shaun Chandler1,3, Dr Dwarakanathan Ranganathan1,4, Dr Kirsten Hepburn1, Dr Eoin O’Sullivan1,3,5, Dr George John1,3, Dr Brian Doucet1,3, Dr Saw Yu Mon1,3, Dr Helen Grania Healy1,2,3, Dr Andrew Kassianos1,2,3, Dr Monica Suet Ying Ng1,2,3,5
1Kidney Health Service, Royal Brisbane And Women’s Hospital, Herston, Australia, 2Conjoint Internal Medicine, Chemical Pathology, Pathology Queensland , Herston, Australia, 3Faculty of Medicine, University of Queensland , Herston, Australia, 4Griffith School of Medicine, Griffith University, Southport, Australia, 5Institute of Molecular Bioscience, University of Queensland , Herston, Australia
Aim: To evaluate kidney biopsy practice and histopathological findings before, during and after the COVID-19 pandemic.
Background: The impact of the COVID-19 pandemic extended beyond direct infection-associated complications. Provision of healthcare services was altered, including kidney biopsy procedures. COVID-19 infection has also been reported to be associated with several glomerular disorders and acute kidney injury.
Methods: All kidney biopsies performed at Royal Brisbane and Women’s Hospital between 2018-2023 were retrospectively analysed. These were divided into pre-pandemic (2018-19), pandemic (2020-21) and post-pandemic (2022-23) eras. Demographic, laboratory, procedural and histopathology data were analysed to determine baseline characteristics and changes over the pandemic course.
Results: There were 229 kidney biopsies performed in 2018-19, 223 in 2020-21 and 213 in 2022-23. Seventy-six percent of biopsies in the pre-covid era were performed by the Nephrology team, with the remaining performed by Interventional Radiology. This was consistent across eras. There was no difference in the proportion of inpatient- versus outpatient procedures. Native kidney biopsies made up >80% of biopsies in all eras. During the COVID-19 pandemic, there was a trend towards more kidney biopsies performed on patients on kidney replacement therapy, however this result was not statistically significant. There were more glomerular disease diagnoses in the post-pandemic era (108/213 [51%] versus 87/229 [38%] pandemic and 94/223 [42%] pre-pandemic). The ratio of biopsies showing glomerular disease to diabetic kidney nephropathy increased during post-pandemic era compared to the pandemic era (P=0.042).
Conclusion: The distribution of kidney biopsy diagnoses were different before, during and after the COVID-19 pandemic. Further analyses are required to determine the factors underpinning these results and compare these findings to those from other centres.
Biography:
Dr Monica Ng is a kidney specialist at Royal Brisbane and Women’s Hospital, senior lecturer at University of Queensland, editorial fellow at Kidney360 and early career clinician scientist. Dr Ng graduated from UQ in 2014 with MBBS with first class honours. She completed her PhD studies in 2019. Dr Ng’s has research interests in developing omics workflows for kidney biomarker discovery, registry analyses for describing kidney disease epidemiology and extracellular vesicles. She is a site PI on multiple clinical trials assessing novel therapies for kidney disease.