Performance of Invasive Procedures by Nephrology Residents in Mexico: Hands-On Training in a Nephrology Training Program

Background: Training in nephrology requires both medical skills and the mastering of technical invasive procedures. It is imperative that the nephrology fellows get adequate training during fellowship to gain the competency and confidence to place a dialysis catheter and kidney biopsy. In Mexico isn't established methodology for assessing invasive procedure competency during training nephrology. The objective of the study was to establish the number of invasive procedures performed by nephrology residents Methods: A record of procedures performed, and complications was collected over a three-year period (March 1, 2022, to February 28, 2025) by fellows in training and supervised by board-certificate nephrologists at a tertiary care hospital in Mexico City Results: This is retrospective, observational and descriptive study. A total of 1,875 hemodialysis-central venous catheter were placed: 1,559 were NTHC and 316 were THC. NTHC were placed by first-year residents while THC were placed by second and third-year residents, three reported cases of vascular injury. A total of 503 percutaneous kidney biopsies were performed: 255 NKB and 248 TKB. NKB were ultrasound-guided by second-year residents, with the puncture performed by first-year residents. Renal graft biopsies were ultrasound-guided by a third-year residents with the puncture performed by first-year residents, two arteriovenous fistulas were reported in TKB and four hematomas in NKB who needed a blood transfusion. Fifty-five PCD was performed by a second-year residents, no major complications were reported, nine PCD were removed and replaced by surgery Conclusion: This study represents the first procedural registry in our hospital. Despite being performed entirely by nephrology residents, complications were minimal. The emergence and establishment of interventional nephrology has credence to the claim that nephrologists, adequately trained, can perform invasive procedures safely and effectively