Knowledge, attitude and practice of renal biopsy among consultant nephrologists and senior nephrology residents

Abstract

Background. Although clinical diagnosis, prognosis, appropriate treatment and monitoring of renal diseases depends on percutaneous renal biopsy-enabled histologic diagnos is , this procedure is uncommonly utilized in Nigeria.

Materials and Methods. This was aquestionnaire based cross sectional study involving consultant nephrologists and senior residents present at an interventional nephrology workshop held at the University of Port Harcourt Teaching hospital, Nigeria in July 2017 as respondents. Questionnaires sought to assess the knowledge, attitude and practice of the respondents to renal biopsy.

Results. The study showed that 89% and 71% of the responding consultants and senior residents respectively, considered renal biopsy important in diagnosis of renal diseases, 90% of the consultants did not perform renal biopsy during their residency training and while 70% did not observe the procedure at all. Also, 41% and 24% percent of the senior residents have neither tried their hands on life renal biopsy nor observed the procedure at all, respectively for upwards of a year in their rank. Eleven percent and 29% of the consultants and senior residents respectively considered renal biopsy unimportant in making diagnosis and 89% relied on serum electrolytes, urea, creatinine, urinalysis and ultrasound scan for diagnosis. High cost and out of pocket payment were the reasons the respondents advanced as being responsible for patients decline from renal biopsy.

Conclusion. The knowledge and attitude of renal biopsy among nephrologists in Nigeria is good, the practice is however low. This is attributable to the inadequate exposure of nephrology residents to renal biopsy during training, lack of trained nephropathologists/necessary diagnostic tools and high cost/out-of pocket payment by patients. Review of residency training curriculum in nephrology and improvement in funding of nephrology practice are imperative for optimization of the nephrology patient.

Keywords: Renal biopsy, Knowledge, Attitude, Practice , Nephrologists, Nigeria