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Aim: Percutaneous renal biopsy is often essential for providing reliable diagnostic and prognostic information for people with suspected kidney disease, however the procedure can lead to complications and concerns among patients. This study aims to identify and integrate patient priorities and perspectives into the Kidney Health Australia - Caring for Australasians with Renal Impairment clinical practice guidelines for renal biopsy, to ensure patient-relevance. Method(s): We convened a workshop, consisting of three simultaneous focus groups and a plenary session, with 10 patients who had undergone a renal biopsy and seven caregivers. Topics and outcomes prioritized by patients and their caregivers were compared to those identified by the guideline working group, which was comprised of seven nephrologists. Transcripts and flipcharts were analyzed thematically to identify the reasons for participants' choices. Result(s): In total, 34 topics/outcomes were identified, 14 of which were common to the list of 28 previously identified by the guideline working group. Most of the new topics identified by patients/caregivers were related to communication and education, psychosocial support, and self-management. We identified five themes underpinning the reasons for topic and outcome selection: alleviating anxiety and unnecessary distress, minimizing discomfort and disruption, supporting family and caregivers, enabling self-management, and protecting their kidney. A new topic on patient care and education was added to the guideline as a result. Conclusion(s): Patient and caregiver involvement in developing guidelines on renal biopsy ensured that their concerns and needs for education, psychosocial support, and self-management were explicitly addressed; enabling a patient-centred approach to renal biopsies.Copyright © 2018 Asian Pacific Society of Nephrology

Aim: Percutaneous renal biopsy is often essential for providing reliable diagnostic and prognostic information for people with suspected kidney disease, however the procedure can lead to complications and concerns among patients. This study aims to identify and integrate patient priorities and perspectives into the Kidney Health Australia - Caring for Australasians with Renal Impairment clinical practice guidelines for renal biopsy, to ensure patient-relevance. Method(s): We convened a workshop, consisting of three simultaneous focus groups and a plenary session, with 10 patients who had undergone a renal biopsy and seven caregivers. Topics and outcomes prioritized by patients and their caregivers were compared to those identified by the guideline working group, which was comprised of seven nephrologists. Transcripts and flipcharts were analyzed thematically to identify the reasons for participants' choices. Result(s): In total, 34 topics/outcomes were identified, 14 of which were common to the list of 28 previously identified by the guideline working group. Most of the new topics identified by patients/caregivers were related to communication and education, psychosocial support, and self-management. We identified five themes underpinning the reasons for topic and outcome selection: alleviating anxiety and unnecessary distress, minimizing discomfort and disruption, supporting family and caregivers, enabling self-management, and protecting their kidney. A new topic on patient care and education was added to the guideline as a result. Conclusion(s): Patient and caregiver involvement in developing guidelines on renal biopsy ensured that their concerns and needs for education, psychosocial support, and self-management were explicitly addressed; enabling a patient-centred approach to renal biopsies.Copyright © 2018 Asian Pacific Society of Nephrology

Aims: This study aims to identify and integrate patient priorities and perspectives into the Kidney Health Australia - Caring for Australasians with Renal Impairment clinical practice guidelines for renal biopsy, to ensure patientrelevance. Background(s): Percutaneous renal biopsy is often essential for providing reliable diagnostic and prognostic information for people with suspected kidney disease, however the procedure can lead to complications and concerns among patients. Method(s): We convened a workshop, consisting of three simultaneous focus groups and a plenary session, with ten patients who had undergone a renal biopsy and seven caregivers. Topics and outcomes prioritised by patients and their caregivers were compared to those identified by the guideline working group, which was comprised of seven nephrologists. Transcripts and flipcharts were analysed thematically to identify the reasons for participants' choices. Result(s): In total, 34 topics/outcomes were identified, 14 of which were common to the list of 28 previously identified by the guideline working group. Most of the new topics identified by patients/caregivers were related to communication and education, psychosocial support, and self-management. We identified five themes underpinning the reasons for topic and outcome selection: Alleviating anxiety and unnecessary distress, minimising discomfort and disruption, supporting family and caregivers, enabling self-management, and protecting their kidney. A new topic on patient care and education was added to the guideline as a result. Conclusion(s): Patient and caregiver involvement in developing guidelines on renal biopsy ensured that their concerns and needs for education, psychosocial support, and self-management were explicitly addressed; enabling a patient-centred approach to renal biopsies.

Aims: This study aims to identify and integrate patient priorities and perspectives into the Kidney Health Australia - Caring for Australasians with Renal Impairment clinical practice guidelines for renal biopsy, to ensure patientrelevance. Background(s): Percutaneous renal biopsy is often essential for providing reliable diagnostic and prognostic information for people with suspected kidney disease, however the procedure can lead to complications and concerns among patients. Method(s): We convened a workshop, consisting of three simultaneous focus groups and a plenary session, with ten patients who had undergone a renal biopsy and seven caregivers. Topics and outcomes prioritised by patients and their caregivers were compared to those identified by the guideline working group, which was comprised of seven nephrologists. Transcripts and flipcharts were analysed thematically to identify the reasons for participants' choices. Result(s): In total, 34 topics/outcomes were identified, 14 of which were common to the list of 28 previously identified by the guideline working group. Most of the new topics identified by patients/caregivers were related to communication and education, psychosocial support, and self-management. We identified five themes underpinning the reasons for topic and outcome selection: Alleviating anxiety and unnecessary distress, minimising discomfort and disruption, supporting family and caregivers, enabling self-management, and protecting their kidney. A new topic on patient care and education was added to the guideline as a result. Conclusion(s): Patient and caregiver involvement in developing guidelines on renal biopsy ensured that their concerns and needs for education, psychosocial support, and self-management were explicitly addressed; enabling a patient-centred approach to renal biopsies.

Aim: To compare Seldinger and laparoscopic techniques for the placement of peritoneal dialysis (PD) catheters, with regards to catheter survival and complications. Background(s): Rates of catheter related complications and catheter survival in PD are partly dependent on the catheter insertion technique. Despite this, the existing literature offers conflicting data on what is the superior catheter insertion technique. Method(s): This was a retrospective analysis of all PD catheters inserted from October 2011 to August 2014 at Eastern Health. Follow-up was continued until April 2015, or until catheter removal. Insertion technique was decided by time of catheter insertion and operator preference. Time to first catheter usage, as well as rates of mechanical and infectious complications were assessed. Differences between groups were analysed by Student's t-test, while catheter survival was determined by Kaplan-Meier statistics. Result(s): Seventy-four catheters (laparoscopic n = 29, Seldinger n = 45) were identified, with mean follow-up of 14.6 +/- 11.7 months. Laparoscopically-inserted catheters were associated with superior catheter survival (p = 0.047) at the end of follow-up. In particular, catheter failure at 6-months was more common in the Seldinger group (42% vs. 21% p = 0.031). Time to first use was 41.2 vs. 19.5 days in the laparoscopic and Seldinger groups respectively (p = ns). Perioperative complications were more common in the laparoscopic group (21% vs. 7%, p = 0.073), with no major complications in the Seldinger approach. Infectious complications were similar between groups. Conclusion(s): Laparoscopically-assisted PD catheter insertion had favourable long-term survival, albeit with possible risks of premature insertion and higher peri-operative complications. In contrast, the Seldinger method was more convenient, and allowed catheter placement closer to the time of starting dialysis.

Aim: To compare Seldinger and laparoscopic techniques for the placement of peritoneal dialysis (PD) catheters, with regards to catheter survival and complications. Background(s): Rates of catheter related complications and catheter survival in PD are partly dependent on the catheter insertion technique. Despite this, the existing literature offers conflicting data on what is the superior catheter insertion technique. Method(s): This was a retrospective analysis of all PD catheters inserted from October 2011 to August 2014 at Eastern Health. Follow-up was continued until April 2015, or until catheter removal. Insertion technique was decided by time of catheter insertion and operator preference. Time to first catheter usage, as well as rates of mechanical and infectious complications were assessed. Differences between groups were analysed by Student's t-test, while catheter survival was determined by Kaplan-Meier statistics. Result(s): Seventy-four catheters (laparoscopic n = 29, Seldinger n = 45) were identified, with mean follow-up of 14.6 +/- 11.7 months. Laparoscopically-inserted catheters were associated with superior catheter survival (p = 0.047) at the end of follow-up. In particular, catheter failure at 6-months was more common in the Seldinger group (42% vs. 21% p = 0.031). Time to first use was 41.2 vs. 19.5 days in the laparoscopic and Seldinger groups respectively (p = ns). Perioperative complications were more common in the laparoscopic group (21% vs. 7%, p = 0.073), with no major complications in the Seldinger approach. Infectious complications were similar between groups. Conclusion(s): Laparoscopically-assisted PD catheter insertion had favourable long-term survival, albeit with possible risks of premature insertion and higher peri-operative complications. In contrast, the Seldinger method was more convenient, and allowed catheter placement closer to the time of starting dialysis.