Education

Specific Formal Instruction

The curriculum is reviewed at the start of each rotation.  Medical problems, health promotion, cultural, socioeconomic, ethical, occupational, environmental, and behavioral issues in rotations are integrated for learning goals and objectives for each rotation and learning experience.  Other educational resources will be provided such as funding for educational materials and attendance of national conferences.  In addition, formal instruction on social and economic impact on medical decisions on patient and society, quality assessment and improvement, and risk management are presented. The nephrology program will afford the fellow the opportunity to achieve cognitive knowledge, procedural skills, interpersonal skills, professional attitudes and behaviors, humanistic qualities, and practical experience to develop into an outstanding nephrologist.

The following topics will be covered by formal instruction in the 2 years of nephrology training:

• Disorders of fluid, electrolyte, and acid-base regulation
• Acute kidney injury
• Chronic kidney  disease and its management including nutritional management of uremia
• Hypertensive disorders – normal and abnormal blood pressure regulation
• Renal disorders of pregnancy
• Urinary tract infections
• Tubulointerstitial renal diseases, inherited diseases of transport, cystic diseases, and other congenital disorders
• Glomerular and vascular diseases, and diabetic nephropathy
• Renal anatomy, physiology, and pathology
• Congenital and acquired diseases of the kidney and urinary tract renal diseases associated with systemic disorders, diabetes and collagen-vascular diseases
• Normal mineral metabolism, metabolic bone disease, renal osteodystrophy and nephrolithiasis
• Clinical pharmacology, drug metabolism and pharmacokinetics and the effects of drugs on renal structure and function; disorders of drug metabolism and renal drug toxicity

Immunology

1. Basic principles
2. Immunologic mechanisms of renal disease
3. Fundamental aspects of diagnostic laboratory immunology relevant to renal diseases

Transplantation

1. Biology of transplantation rejection
2. Indications for and contraindications to renal transplantation
3. Principles of transplant recipient evaluation and selection
4. Principles of evaluation of transplant donors, both live and cadaveric, including histocompatibility testing
5. Principles of organ harvesting, preservation, and sharing
6. The pathogenesis and management of urinary tract infections
7. The pathogenesis and management of acute renal failure
8. Indications for and interpretations of radiologic tests of the kidney and urinary tract
9. Disorders of fluid, electrolytes and acid-base balance specific to transplantation.         

Indications for and interpretations of radiologic tests of the kidney and urinary tract

End-stage renal disease/dialysis

1. The kinetic principles of hemodialysis and peritoneal dialysis
2. The indications for each mode of dialysis
3. The short-term and long-term complications of each mode of dialysis and management
4. The principles of dialysis access (acute and long-term vascular and peritoneal), including indications, placement techniques, complications, diagnosis (radiology), and treatment of complications ( e.g. angioplasty of vascular access)
5. Urea kinetics and protein catabolic rate
6. Dialysis modes and their relation to metabolism
7. Nutritional management of dialysis patients
8. Dialysis water treatment, delivery systems, and reuse of artificial kidneys
9. The artificial membranes used in hemodialysis and biocompatibility; and
10. The psychosocial and ethical issues of dialysis
11. Aspect of long term-care (e.g. renal osteodystrophy-bone biopsy) for longitudinal follow up.

Geriatric aspects of Nephrology