Nephrology and Hypertension

You will work under faculty and fellows who are extremely committed to teaching and will work closely with you to ensure a broad-based knowledge of this topic is passed on. 

You will be responsible for performing inpatient consultations and in some cases, admitting patient to the nephrology service. Additionally, you will see patients in the outpatient clinic and during hemodialysis.

This rotation is spent at Oishei Children’s Hospital for two months, split with hematology/oncology. Renal patients both new and follow-up are examined under the supervision of pediatric nephrology attendings. 

Abnormal physical findings, complications, therapeutic implications are discussed in depth with the supervising attending. Disposition and appropriate follow-up are arranged. Discussions with parents about patients with renal abnormalities are done and guided by the clinic attending. Inpatient rounds are made as part of the didactic sessions when appropriate.

The goals and objectives of the rotation are to:

• know the major problems that suggest the presence of renal disease:
  • abnormal urinalysis
  • urinary tract infection
  • hypertension
  • edema
  • fluid, electrolyte and acid-base disorders
  • growth failure
  • abdominal pain or mass
  • congenital anomalies
  • exposure to nephrotoxic medication
  • systemic disease known to be associated with kidney involvement
• recognize the above problems using history, physical examination and/or laboratory studies
• accurately evaluate and properly treat a dehydrated child, a child with hyponatremia and a child with hypernatremia
• provide a comprehensive differential diagnosis of kidney disorders 
• formulate an initial management plan including diagnostic procedures and therapy 
• accurately evaluate and properly treat a child with a hypertensive emergency and a child with severe hyperkalemia
• outline appropriate long-term management for kidney diseases 
• understand the limitations and side effects of laboratory tests, diagnostic procedures and therapeutic measures used when managing childhood renal disease
• establish appropriate guidelines for patient referral to a pediatric nephrologist

Topics relating directly to the potential problems or complications of renal patients are discussed formally weekly.

Work directly with the nephrology attending in clinic, in dialysis, and in conference.

PGY-2, PGY-3 or PGY-4

Two modules (4 weeks each)

• The demographics for this rotation are very broad. The hospital has an 8-county encatchment area that allows the learner to see patients of varied backgrounds including everything from inner city to rural and special populations such as Amish.
• You will be exposed to relatively common issues such as pediatric hypertension and minimal change disease to less common etiologies of renal disease such as Bartter syndrome and FSGS.