A competency based development of knowledge and skills in Nephrology through clinical experience, bedside teaching, didactic conferences and readings to achieve competence, proficiency and the foundation for mastery. Clinical Information and Didactics - Residents will function as integral members of the Nephrology Consultation Service.
- Housestaff and medical students should contact the Nephrology Consult Fellow (312) 926-1696 at the inpatient HD unit the day before starting the Consult Service for Rotation orientation.
- Weekend calls at NMH are divided between housestaff assigned at the beginning of the Rotation.
- Transplant Nephrology Service is an option only for those who have already rotated through the Nephrology Consult Service or by approval of the Division Chair.
- Chronic Dialysis Service is an option only for those who have already rotated through the Nephrology Consult Service or by approval of the Division Chair.
- Scheduling of rounds will be determined on a daily basis with the faculty member. Residents will be permitted to leave at 6:00 pm, in the event that rounds run later into the evening.
| Monday | Tuesday | Wednesday | Thursday | Friday | AM | 7:30 am Morning Report | 7:30 am Grand Rounds 8:30am Renal Teaching Conf (Searle bldg, 10th flr) | 7:30 am Morning Report | 7:30 am Morning Report 8:30am Renal Teaching Conf (Searle bldg, 10th flr) | 7:30 am Morning Report | PM | 1pm- every other wk Journal Club (Searle bldg, 10th flr) |
| 1pm Fellows Clinical Conference (676 bldg, 14th flr) | 3pm- every other wk Curriculum Conference (Searle bldg, 10th flr) |
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- Residents will be expected to attend all Nephrology specific conferences scheduled above.
- Inpatient dialysis: NMH Feinberg Pavilion, 9-748. Phone- 6-1696.
- Outpatient dialysis: Olson Pavilion, 4th floor. Phone (312) 274-0202.
: Click here Practice Based Learning and Improvement PGY1: Incorporate regular chart review and patient follow up to learn from your clinical care. Teach and mentor students. PGY2/3: Incorporate evidence based medicine into clinical decision making. Review the latest research pertaining to your your patients. Teach and mentor students and interns. Systems Based Practice PGY1: Work in a multi-disciplinary team to provide high quality coordinated care. Ensure accurate and timely documenation through the use of the electronic medical record. PGY2/3: Use knowledge and skills in quality improvement and patient safety to deliver safe and effective care. Apply team leadership skills in appropriate settings. Practice cost effective medicine with an awareness of health care economics and patient insurance status. Interpersonal Skills and Communication PGY1: Use effective listening skills with patients and health care providers. Elicit and provide information using effective nonverbal, explanatory, questioning, and writing skills. PGY2/3: Develop interpersonal and communication skills necessary to run an effective clincal team in the ambulatory. Role model and teach effective communication techniques. Professionalism PGY1: Carry out your professional responsibilities in a timely manner. Adhere to the ethical principles of a patient-centered practice. Be sensitive to a diverse patient population and health care staff. PGY2/3: Understand how biases influence clinical care, patient-physician interactions and health team interactions. Role model and provide feedback to students and interns the principles of humanism in medicine. Patient Care and Medical Knowledge - Formulate the differential diagnosis, evaluation, and management of acute renal failure.
- Determine when aggressive conservative therapy is warranted versus dialysis.
- Differentiate between acute and chronic renal failure.
- Describe the parameters used to determine when dialysis should be initiated.
PGY2,3- Define the complications of chronic renal failure and appropriate management of each:
- Anemia
- Bone disease
- Hypertension
- Dietary modification
- Acidosis
- Compare and contrast hemodialysis, peritoneal dialysis, and kidney transplantation. Discuss with the Nephrology service and consulting service which may be preferable for the patient and why.
- Describe 5 common complications of each of the above-mentioned renal replacement therapies.
- Identify 5 structures that may be found on urine sediment and the significance of its presence.
- Identify causes of secondary hypertension and appropriate workup.
- Propose specific antihypertensive regimens for patients seen on the Consult Service.
- Discuss the causes, evaluation, and management of:
- Hyperkalemia
- Hypokalemia
- Hypernatremia
- Hyponatremia
- Hypercalcemia
- Hypocalcemia
- Calculate acid/base disorders using basic chemistry panel and arterial blood gas measurements.
- Observe temporary hemodialysis catheter placement by the Nephrology Fellow.
- Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999 Mar 16 ;130(6):461-70.
- Gluck SL. Acid-base. Lancet. 1998 Aug 8;352(9126):474-9. Review.
- Halperin ML, Kamel KS. Potassium. Lancet. 1998 Jul 11;352(9122):135-40. Review.
- Bushinsky DA, Monk RD. Electrolyte quintet: Calcium. Lancet. 1998 Jul 25;352(9124):306-11. Review.
- Kumar S, Berl T. Sodium. Lancet. 1998 Jul 18;352(9123):220-8. Review.
- Weisinger JR, Bellorin-Font E. Magnesium and phosphorus. Lancet. 1998 Aug 1;352(9125):391-6. Review.
- Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function--measured and estimated glomerular filtration rate. N Engl J Med. 2006 Jun 8;354(23):2473-83.
Acute - Barrett BJ, Parfrey PS. Clinical practice. Preventing nephropathy induced by contrast medium. N Engl J Med. 2006 Jan 26;354(4):379-86. Review.
- Marenzi G, Assanelli E, Marana I, Lauri G, Campodonico J, Grazi M, De Metrio M, Galli S, Fabbiocchi F, Montorsi P, Veglia F, Bartorelli AL. N- acetylcysteine and contrast-induced nephropathy in primary angioplasty. N Engl J Med. 2006 Jun 29;354(26):2773-82.
- Mehta RL. Continuous renal replacement therapy in the critically ill patient. Kidney Int. 2005 Feb;67(2):781-95.
- Ronco C, Bellomo R, Homel P, Brendolan A, Dan M, Piccinni P, La Greca G. Effects of different doses in continuous veno-venous haemofiltration on outcomes of acute renal failure: a prospective randomised trial. Lancet. 2000 Jul 1;356(9223):26-30.
- Schiffl H, Lang SM, Fischer R. Daily hemodialysis and the outcome of acute renal failure. N Engl J Med. 2002 Jan 31;346(5):305-10.
- Stacul F, Adam A, Becker CR, Davidson C, Lameire N, McCullough PA, Tumlin J; CIN Consensus Working Panel. Strategies to reduce the risk of contrast-induced nephropathy. Am J Cardiol. 2006 Sep 18;98(6A):59K-77K. Epub 2006 Mar 20. Review.
- Thadhani R, Pascual M, Bonventre JV. Acute renal failure. N Engl J Med. 1996 May 30;334(22):1448-60. Review.
Chronic - Hou FF, Zhang X, Zhang GH, Xie D, Chen PY, Zhang WR, Jiang JP, Liang M, Wang GB, Liu ZR, Geng RW. Efficacy and safety of benazepril for advanced chronic renal insufficiency. N Engl J Med. 2006 Jan 12;354(2):131-40.
- Drueke TB, Locatelli F, Clyne N, Eckardt KU, Macdougall IC, Tsakiris D, Burger HU, Scherhag A; CREATE Investigators. Normalization of hemoglobin level in patients with chronic kidney disease and anemia. N Engl J Med. 2006 Nov 16;355(20):2071-84.
- Singh AK, Szczech L, Tang KL, Barnhart H, Sapp S, Wolfson M, Reddan D; CHOIR Investigators. Correction of anemia with epoetin alfa in chronic kidney disease. N Engl J Med. 2006 Nov 16;355(20):2085-98.
- Wolf G, Ritz E. Combination therapy with ACE inhibitors and angiotensin II receptor blockers to halt progression of chronic renal disease: pathophysiology and indications. Kidney Int. 2005 Mar;67(3):799-812. Review.
Transplant - Halloran PF. Immunosuppressive drugs for kidney transplantation. N Engl J Med. 2004 Dec 23;351(26):2715-29. Review.
Collection by Dr. Bijal Jain and Dr. Albert Lam For an extended list of references with direct article links, sign in to the Galter Health Library website at: http://www.galter.northwestern.edu/guides/expand/resident-reading-lists |
