title: Beyond complications: Comparison of procedural differences and diagnostic success between nurse practitioners and radiologists performing image-guided renal biopsies.
abstract: OBJECTIVE
  Radiology-trained nurse practitioners (NPs) may perform image-guided medical renal biopsies with computed tomography (CT). This study evaluates the procedural differences and diagnostic success between biopsies performed by NPs compared to radiologists.
  
  
  METHODS
  A retrospective study was performed on patients who underwent nontargeted, CT-guided renal biopsy between 2009 and 2014. Provider type (NP or radiologist), number of core specimens obtained, sedation medication dose, CT dose index (CTDI), and diagnostic success were recorded. Categorical and continuous variables were analyzed using χ2and Student's two-tailed t-test, respectively, comparing NPs with radiologists.
  
  
  CONCLUSIONS
  A total of 386 patients were included; radiologists performed 215 biopsies and NPs performed 171 biopsies. There was no significant difference in diagnostic success, amount of tissue harvested (number of cores), radiation dose, or sedation dosage between NPs and radiologists performing CT-guided renal biopsies. Only 4% were nondiagnostic (n = 7, radiologists; n = 9, NPs; p = .325). Overall mean number of cores obtained was 3.7, mean CTDI was 176.5 mGy, mean fentanyl dose was 86.3 μg, and mean midazolam was dose 1.54 mg without a statistically significant difference between provider types.
  
  
  CONCLUSIONS
  NPs perform image-guided medical renal biopsies in a similar fashion to radiologists with respect to diagnostic success, amount of tissue harvested, total radiation dose exposure, and administration of sedation.
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia. snandwa@emory.edu.
authors.forename: Sadhna B
authors.initials: SB
authors.lastname: Nandwana
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Deborah G
authors.initials: DG
authors.lastname: Walls
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Oluwayemisi
authors.initials: O
authors.lastname: Ibraheem
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Frederick
authors.initials: F
authors.lastname: Murphy
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Srini
authors.initials: S
authors.lastname: Tridandapani
authors.affiliation: Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia.
authors.forename: Kelly
authors.initials: K
authors.lastname: Cox
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000592:standards*; D007668:Kidney / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners / Q000592:standards*; D000072177:Radiologists / Q000592:standards*; D012189:Retrospective Studies
keywords: Nurse practitioners; kidney; physicians; renal biopsy; research; role of advanced practice nurse