Residency Subspecialty Education

The Renal Service is a very active and productive division. The division has a large outpatient and inpatient program. Both glomerular and tubular disorders as well as de novo glomerulopathies in the context of renal transplant are well represented. The division serves a large nephrotic syndrome population. Renal disorders, both idiopathic and secondary to systemic diseases, such as SLE, are routinely seen. Our inpatient service occupies a substantial number of beds at UHB NS42 throughout the year. Patients on the inpatient service have complex fluid and electrolyte problems, acute rejections of their kidney allografts, and frequently are in acute renal failure. In addition, the Renal Service operates one of the country's largest pediatric maintenance hemodialysis units providing renal replacement therapy 6 days a week in three shifts. This complex operation is constantly monitored by Pediatric Board Certified fellows and supervised by 2 Pediatric Nephrology Board Certified attendings. We also have an active transplant program, we have established an excellent track record in long-term survival of both living related and cadaveric donor transplants. The division has a accredited pediatric nephrology fellowship training program.

Residents rotation on this service participate in the care and daily follow-up of patients, primarily end-stage renal disease and renal transplants recepients, admitted under the Renal Service at UHB. In addition, residents serve as supervised consultants for inpatients and outpatients at both UHB and KCHC for problems including renal dysfunction, fluid and electrolyte disorders, hypertension, poisonings, and infection. The residents follow progress of patients presenting for routine chronic dialysis. Residents attend and provide supervised direct patient care in 3 clinics per week. Didactics include weekly divisional clinical rounds, weekly biopsy conference, weekly journal club and research conference, and daily rounds, and residents are expected to attend all departmental conferences. Several sessions are held for topic discussions including electrolyte disorders, hypertension, glomerulonephritis, nephrosis, hematuria, UTI.

Research efforts of our division are very successful. Our fellows present at national and international meetings. There is an extensive bibliography generated by this service on various aspects of renal transplantation, such as vascular thrombosis, chronic rejection, graft survival and growth post-transplantation. In addition, we have produced numerous peer-reviewed articles on nephrotic syndrome and other glomerular disorders.