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Training young nephrologists in interventional nephrology is an unmet need, especially in developing countries. Theoretical knowledge is easy to test, however, applying it in practice reveals potential errors. Training on real patients raises ethical concerns, as participants may feel stressed, and patients may feel anxious if they perceive themselves as teaching tools. There are available kidney biopsy models, but their costs are way beyond the financial ability of medical facilities in developing countries. There is a need for cost-effective, anatomically accurate models that replicate clinical situations, allowing trainees to practice without stress and reduce the risk of medical errors.
We constructed a model for renal biopsy and another one for dialysis catheter insertions.
For the renal biopsy model, we needed an animal kidney that resembles a human kidney and a media that is suitable for both sonographic imaging and needle passage. We got sheep kidneys from the supermarket (1 kidney = 1 USD) as they were similar in shape and ultrasound appearance to human kidneys (Figure 1). For the media, we used commercial gelatin that is used in desserts (1kg = 3 USD). The steps for making the kidney model are illustrated in Figure 1. If you have a large plastic box (1 box = 1 USD), you can put more than one kidney in it. Gelatin should be preserved in the refrigerator and be taken out just before the training.
Using these models, we organized a hands-on workshop for training young nephrologists in April 2023. More than 35 nephrologists were able to experience, most of them for the first time, ultrasound-guided kidney biopsy. The ultrasound image and kidney cores were similar to real-life practice (Figure 2). The feedback from participants was very positive, and this helped them to be more confident in the next steps of management of the real patients.
These gelatin-based home-made models costed less than 5 USDs can make young nephrologists familiar with kidney biopsy techniques without the need of very expensive phantoms and help to overcome the complexity and ethical debates of the first-time real-life training.