Percutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement Activity
Background: An adequate renal biopsy is essential for diagnosis and treatment of medical renal disease. Objective: We evaluated two initiatives to improve adequacy of renal biopsy samples at our centre. Design: Retrospective determination of renal biopsy adequacy. Setting: Queen Elizabeth II Health...
Main Authors: | , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
SAGE Publishing
2015-03-01
|
Series: | Canadian Journal of Kidney Health and Disease |
Online Access: | https://doi.org/10.1186/s40697-015-0043-z |
id |
doaj-c4c891162f624768be8f96eaf2dc76cc |
---|---|
record_format |
Article |
spelling |
doaj-c4c891162f624768be8f96eaf2dc76cc2020-11-25T01:27:14ZengSAGE PublishingCanadian Journal of Kidney Health and Disease2054-35812015-03-01210.1186/s40697-015-0043-zPercutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement ActivityLaurette Geldenhuys0Peter Nicholson1Namita Sinha2Angela Dini3Steve Doucette4Talal Alfaadhel5Valerie Keough6Michael West7 Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Department of Pathology and Laboratory Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada Department of Diagnostic Imaging, Dalhousie University, Halifax, Nova Scotia, Canada Department of Medicine, Dalhousie University, Halifax, Nova Scotia, CanadaBackground: An adequate renal biopsy is essential for diagnosis and treatment of medical renal disease. Objective: We evaluated two initiatives to improve adequacy of renal biopsy samples at our centre. Design: Retrospective determination of renal biopsy adequacy. Setting: Queen Elizabeth II Health Sciences Centre. Patients: Patients undergoing medical renal biopsies. Measurements: Renal biopsy adequacy. Methods: The first initiative was to restrict the performance of biopsies to a smaller group of radiologists and to include a comment on biopsy adequacy in every pathology report. The second initiative was to introduce on-site adequacy assessment by a medical laboratory technologist. Native renal and allograft biopsy adequacies were calculated for three periods: 1) baseline, October 2005 to September 2006; 2) after implementation of the first initiative, January 2007 to September 2011; and 3) after implementation of the second initiative, October 2011 to September 2012. A subset of native renal biopsies was examined to determine if there was a relationship between adequacy and number of passes. Results: The percentages of adequate native renal biopsies during the first, second, and third periods were 31%, 72% and 90%, respectively. This represents a significant increase (40%, p < 0.0001) in adequacy following the first initiative, and another significant increase (18%, p = 0.0003) following the second initiative. The percentages of adequate renal allograft biopsies during the first, second, and third periods were 75%, 56% and 69%, respectively. These changes in adequacy were not statistically significant. In the subset of native renal biopsies examined, a biopsy comprising more than three cores was not associated with increase in adequacy. Limitations: The most important limitation is the lack of generally accepted and applied adequacy criteria limiting generalizability of our findings. Conclusions: Restricting the performance of biopsies to subspecialist operators, including an adequacy statement in the renal biopsy report and on-site adequacy assessment were effective in significantly improving native renal biopsy adequacy. This improvement appeared unrelated to an increase in the number of passes taken with a biopsy needle. Neither initiative improved the low adequacy of allograft biopsies.https://doi.org/10.1186/s40697-015-0043-z |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Laurette Geldenhuys Peter Nicholson Namita Sinha Angela Dini Steve Doucette Talal Alfaadhel Valerie Keough Michael West |
spellingShingle |
Laurette Geldenhuys Peter Nicholson Namita Sinha Angela Dini Steve Doucette Talal Alfaadhel Valerie Keough Michael West Percutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement Activity Canadian Journal of Kidney Health and Disease |
author_facet |
Laurette Geldenhuys Peter Nicholson Namita Sinha Angela Dini Steve Doucette Talal Alfaadhel Valerie Keough Michael West |
author_sort |
Laurette Geldenhuys |
title |
Percutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement Activity |
title_short |
Percutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement Activity |
title_full |
Percutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement Activity |
title_fullStr |
Percutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement Activity |
title_full_unstemmed |
Percutaneous Native Renal Biopsy Adequacy: A Successful Interdepartmental Quality Improvement Activity |
title_sort |
percutaneous native renal biopsy adequacy: a successful interdepartmental quality improvement activity |
publisher |
SAGE Publishing |
series |
Canadian Journal of Kidney Health and Disease |
issn |
2054-3581 |
publishDate |
2015-03-01 |
description |
Background: An adequate renal biopsy is essential for diagnosis and treatment of medical renal disease. Objective: We evaluated two initiatives to improve adequacy of renal biopsy samples at our centre. Design: Retrospective determination of renal biopsy adequacy. Setting: Queen Elizabeth II Health Sciences Centre. Patients: Patients undergoing medical renal biopsies. Measurements: Renal biopsy adequacy. Methods: The first initiative was to restrict the performance of biopsies to a smaller group of radiologists and to include a comment on biopsy adequacy in every pathology report. The second initiative was to introduce on-site adequacy assessment by a medical laboratory technologist. Native renal and allograft biopsy adequacies were calculated for three periods: 1) baseline, October 2005 to September 2006; 2) after implementation of the first initiative, January 2007 to September 2011; and 3) after implementation of the second initiative, October 2011 to September 2012. A subset of native renal biopsies was examined to determine if there was a relationship between adequacy and number of passes. Results: The percentages of adequate native renal biopsies during the first, second, and third periods were 31%, 72% and 90%, respectively. This represents a significant increase (40%, p < 0.0001) in adequacy following the first initiative, and another significant increase (18%, p = 0.0003) following the second initiative. The percentages of adequate renal allograft biopsies during the first, second, and third periods were 75%, 56% and 69%, respectively. These changes in adequacy were not statistically significant. In the subset of native renal biopsies examined, a biopsy comprising more than three cores was not associated with increase in adequacy. Limitations: The most important limitation is the lack of generally accepted and applied adequacy criteria limiting generalizability of our findings. Conclusions: Restricting the performance of biopsies to subspecialist operators, including an adequacy statement in the renal biopsy report and on-site adequacy assessment were effective in significantly improving native renal biopsy adequacy. This improvement appeared unrelated to an increase in the number of passes taken with a biopsy needle. Neither initiative improved the low adequacy of allograft biopsies. |
url |
https://doi.org/10.1186/s40697-015-0043-z |
work_keys_str_mv |
AT laurettegeldenhuys percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity AT peternicholson percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity AT namitasinha percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity AT angeladini percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity AT stevedoucette percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity AT talalalfaadhel percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity AT valeriekeough percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity AT michaelwest percutaneousnativerenalbiopsyadequacyasuccessfulinterdepartmentalqualityimprovementactivity |
_version_ |
1725105884873359360 |