At its meeting of 9 July 2014, the Board of Directors of the Spanish Society of Nephrology (SEN) approved the creation of the SEN Working Group on Diagnostic and Interventional Nephrology (DIN). This letter, based on the group's founding document, which is available on the SEN website, aims to set forth the reasons why it is necessary to create this group, its objectives and its plan for action.
Ultrasound is an essential tool in the practice of medicine, with multiple applications in kidney patients. In addition to being a very informative and non-invasive diagnostic method, it is the vehicle through which interventions such as biopsy on the kidneys may be performed.1–5 Furthermore, it is crucial for performing various interventions that are not strictly related to the kidneys, but are the responsibility of the nephrologist, such as placing central lines and managing arteriovenous fistulas for haemodialysis.6 Finally, it allows the arteries to be visualised for early diagnosis of subclinical artery disease, or evolution of atheromatous disease, which is known to be the basis of the majority of cardiovascular events and mortality in the general population and to an even greater extent in the kidney population.7
For this reason, it is important that the nephrologist learn appropriate ultrasound techniques so as to perform and interpret ultrasound examinations in order to achieve more comprehensive and efficient patient management.
Suitable and timely placement of the appropriate catheter for peritoneal dialysis determines the prognosis for the patient and the technique. The nephrologist is trained to place and remove peritoneal catheters, and this is in fact what happens in some Spanish departments of Nephrology.
The above set of activities is called DIN. It is a subspecialty of nephrology that has been expanding since it was named and defined in 2000.1,8–10 Several scientific societies of nephrology have working groups in this regard, such as the American Society of Diagnostic and Interventional Nephrology (ASDIN), the Latin American Society of Nephrology and Hypertension (SLANH), the Argentinian Society of Nephrology (SAN) and, most recently, the Chilean Society of Nephrology (SCN).
There is significant demand among Spanish nephrologists for training in this field. In the majority of nephrology departments, these activities are assigned to other units and departments, and there is growing dissatisfaction when it is seen that patients’ clinical care needs are not suitably covered. Performing activities related to the diagnosis of kidney disease, which revolve around ultrasound, as well as recovery from nephrology interventions, would represent not only significant healthcare improvement, but also a boost to the specialty, rendering it more attractive to future residents, and probably an improvement in career opportunities.
Aware of this demand, the Board of Directors of the SEN has sponsored various university courses, such as the University Master's Degrees in Imaging of the Nephrology Departments at Hospital Universitario Ramón y Cajal in Madrid (Universidad Alcalá de Henares) and Hospital Universitario Arnau de Vilanova (Universitat de Lleida) and the vascular access ultrasound course at Hospital de Sabadell.
We believe that the creation of a Working Group on DIN could give a major boost to the expansion of this discipline and would allow for the greater participation of Spanish nephrologists. This could make the specialty more attractive for future generations.8–10
The fundamental objective of the Working Group on DIN is to incorporate ultrasound into the nephrologist's clinical practice and to re-establish techniques specific to our specialty as part of the central role of the nephrologist. Therefore, its activity shall consist of: bringing together all nephrology specialists who are interested in or who perform DIN in part or in full, as well as boosting the implementation of DIN in the nephrology departments in Spain that are in favour. We shall provide training and scientific activities in the field of DIN through specific courses and workshops. Finally, we would like to promote contacts and joint activities with scientific societies for related specialties, to join forces in a multidisciplinary approach and in the interests of collaborative research.
To carry out these objectives, given that DIN encompasses a broad spectrum of activities, we have considered dividing the activity of the group into several sections (kidney, cardiovascular risk and peritoneal dialysis) for which one or more of the founding members would be responsible. The group is open to broadening its field of action to new disciplines based on incorporating ultrasound into nephrology that may be useful for the nephrologist's routine clinical practice, and that do not enter into conflict with other SEN groups that have already been established.
We encourage all nephrologists interested in performing and promoting DIN to join the group.
Please cite this article as: Rivera Gorrín M, Cornago Delgado I, Betriu Bars À, Lanuza Luengo M, Ceballos Guerrero M, Paraíso Cuevas V, et al. Creación del Grupo de Trabajo en Nefrología Diagnóstica e Intervencionista de la Sociedad Española de Nefrología. Nefrología. 2016;36:325–326.
