The results from last week's Poll of the Week are in, and in general, a majority of individuals (64%) felt that their training programs did a good job of teaching them the art of the renal biopsy, while a significant minority (36%) felt that they were ill-equipped to perform biopsies at the end of their fellowship experience. Interestingly, there was an identical breakdown of those who felt that nephrologists' renal biopsy skills are still relevant (64%) compared to those who felt that it's okay to leave the biopsies up to the interventional radiologists (36%). Here is another way to look at the results:
A 2008 CJASN article by Drs. Berns and O'Neill ("Performance of procedures by nephrologists and nephrology fellows at U.S. nephrology training programs") states that virtually all nephrology fellowship programs provide training in renal biopsies, with about half of those training programs providing the fellow with instruction in hands-on renal ultrasonography. Interestingly, the number of biopsies required for "certification" in each program varies widely, from only two to up to fifteen, and very few professional guidelines exist which specifically address what should constitute adequate training for kidney biopsy.
Check out the latest Renal Fellow Poll of the Week on the left, which has to do with the newly-proposed Kidney Allocation System (KAS). Because the Poll widget only allows the question to be rather short, I had to radically simplify what the plan proposes--I openly acknowledge that the plan is more complex than making it "easier for younger patients to get transplants, but harder for older ones", so to read a more detailed description of precisely what the KAS plan is, you can click here .