Download Clinical curriculum: Renal structure and function Fellows will acquire

Clinical curriculum: Renal structure and function
Fellows will acquire expertise in understanding normal renal biology including renal anatomy and
histology, renal physiology, fluid and electrolyte regulation, acid-base balance, mineral metabolism, blood
pressure regulation, renal drug metabolism and pharmacokinetics, drug effects on renal function, renal
function in pregnancy, renal functional changes with aging, and basic immunologic principles.
1) Educational training
a. Handouts - At the beginning of the Fellowship, Fellows are given several books for their personal
use. The books include: Clinical Nephrology (Johnson and Feehally), Urinalysis (Sister Martine
Graf), Handbook of Dialysis (Daugirdas and Ing), Handbook of Renal Transplantation
(Danovitch), the AST Handbook of Transplant Infections (Kumar and Humar), and How the
Immune System Works (Sompayrac). Fellows are also given access to UpToDate. While many
of these sources primarily deal with renal disorders, they provide fundamental information on
normal renal biology as well.
b. Didactic sessions - While normal renal biology is discussed during more informal sessions
(attending rounds, renal clinics) it is recognized that a structured approach is necessary to
guarantee coverage of the basics of normal renal biology. To accomplish this, a didactic
conference is held each Friday from 11:30-12:30 PM for 2 years. During the session, a faculty
member facilitates discussion of the assigned material. A one-hour session is devoted to each
of the following normal renal biology topics: water handling, potassium balance, sodium and
volume, acid-base balance, Ca/Mg/PO4 metabolism, renal immunology, blood pressure
regulation, and renal function in pregnancy. Drug metabolism is discussed during several
sessions dealing with antihypertensives, immunosuppressants, and other topics. Renal
anatomy and histology are extensively discussed during several sessions on glomerular and
interstitial diseases in which diseased kidneys are compared to normal kidneys.
c. Conferences - A renal pathology conference is held each Friday from 12:30-1:30 PM. Diseased
kidneys are compared to normal kidneys throughout this conference. Fellows use a multiheaded microscope is for simultaneous viewing.
2) Nature of supervision - A faculty member facilitates discussion of the assigned material during the
didactic sessions. A renal pathology attending supervises discussion of the cases during the
pathology conference.
3) Means of Fellow evaluation - Faculty members give Fellows immediate feedback on their
knowledge base during the didactic sessions. At the end of each year of didactic sessions, the
Fellows take an in-house MKSAP test in Nephrology and Hypertension. Fellows are counseled on
areas of weakness by the Program Director. Also, please see information on knowledge base
assessment in the General Nephrology section – much of the information covered in basic renal
structure and function overlaps with that required for General Nephrology.