M ALJISHI1, S NASR1, T HAN1,2, Z THET1,2,3
1Central Queensland Hospital and Health Service, Rockhampton, Australia, 2Rural Clinical School, The University of Queensland, Rockhampton, Australia, 3Griffith University, Rockhampton, Australia
Background: There is a concern that biopsy risks are higher in regional Australian centres, where lack of interventional support makes management of complications difficult. Central Queensland Hospital and Health Service (CQHHS) started performing kidney biopsies in 2005 by nephrologists and then by onsite radiology from 2016 onwards. To date, no studies have evaluated epidemiology of kidney disease and safety of kidney biopsy in the Central Queensland.
Aim: The aim is to determine the epidemiology of biopsy-proven kidney disease in CQHHS and the safety of kidney biopsies.
Methods: A retrospective study on native kidney biopsies in CQHHs was performed. Biopsy data from January 2005 to December 2019 was obtained from health records. Biopsies performed in CQHHS Radiology were examined for biopsy-related complications.
Results: 187 kidney biopsies occurred during the study period, of which 170 (91%) were native biopsies. The number of kidney biopsies per year has steadily increased from around 7 to 17 biopsies a year. The average age of patients undergoing biopsy was 51 years, and the average renal function was 48 mL/min/1.73m2. The most common indications for biopsy were acute renal failure (54%), nephritic syndrome (34%), subnephrotic proteinuria (30%), and nephrotic syndrome (30%). The most common biopsy diagnoses were IgA Nephropathy (16%), diabetic nephropathy (12%), and membranous nephropathy (11%). The left kidney was targeted in 70% of biopsies and the average size was 11.3 cm. Ultrasound was used in 96% of biopsies. 10 out of 60 (17%) biopsies had a complication, predominantly minor uncomplicated haematoma while two needed intervention without any mortality.
Conclusions: Kidney biopsy practice in CQHHS appears safe and provides important epidemiological data on biopsy-proven kidney disease.
I am a second-year renal advanced trainee in Nephrology who has completed MBChB in University in Auckland in 2011 and gained FRACP in General Medicine in 2020. I have published in many journals, including NEJM, BMJ and NZMJ. I am also an associate lecturer at the University of Queensland.