Methodology

1.  Interventional Nephrology Service 
The Interventional Nephrology Service is an inpatient/outpatient service designed to care for patients with end-stage kidney disease (ESRD) and chronic kidney disease (CKD) who require diagnostic and/or treatment related to vascular access for hemodialysis, peritoneal dialysis, or kidney biopsy. The Interventional Nephrology service sees patients on the 6th floor of the North Pavilion building, Heart Vascular Center (room # 5). The Interventional Nephrology team includes the Nephrology attending, Interventional Radiology attending, and one Nephrology fellow each month.

Responsibilities of the renal Fellow on this rotation include, but are not limited to:

  1. Evaluating the need for dialysis in patients who come to the Heart Vascular Center for an Interventional Nephrologic procedure.
  2. Be the primary or secondary operator of the Interventional Nephrology procedures.
  3. Performing or guiding first year Nephrology fellows in renal biopsies in outpatients and inpatients.
  4. Follow-up all patients who underwent an Interventional Nephrologic procedure until they are discharged from the Heart Vascular Center.

Essential in this role is the development and refinement of clinical skills in the evaluation, diagnosis, treatment, and follow-up of patients with vascular access issues. These skills include developing appropriate differential diagnoses, assessing the need for hospitalization, and implementing diagnostic strategies and treatment plans. Through this experience the fellow will also develop a comprehensive understanding of the indications, contraindications, techniques, and complications of vascular access for hemodialysis, peritoneal dialysis, vascular access placement, and renal biopsies. The fellow will also acquire skills in educating patients about these procedures and in obtaining informed consent.

2.    Interdisciplinary Interactions

The second and third year fellows also will be provided with the opportunity to interact with staff of the Interventional Radiology Division.

3.    Didactic Conferences 

The Interventional Nephrology fellow is encouraged to attend all the conferences held on a regularly scheduled basis by the Division of Nephrology.  A monthly Vascular Access for Hemodialysis conference is scheduled every third Wednesday of the month. The Interventional Nephrology fellow is encouraged to attend the Interventional Radiology conference every Tuesday at the Heart Vascular Center conference room and to the monthly Morbidity and Mortality report conference held every third Thursday of the month. They are encouraged to give lectures to the interventional section (radiology and nephrology) on the already set-up lecture times.

4.    Research Experience

The primary goal of the research experience is for the fellow to learn sound methodology in designing and performing research studies and the correct interpretation and synthesis of research data.  During this phase of training, the fellow will work under close guidance of the research mentor from either the Nephrology or Interventional Radiology Divisions. Fellows working on specific research projects will be given adequate uninterrupted, protected time to pursue the research goals. Another goal of the research experience is to develop a body of work suitable for presentation at national scientific meetings and publication in peer-reviewed journals. For those fellows who are interested in an academic career, this body of work should lay the foundation for applications of extramural funding.

5.  Experience In Developing Teaching Skills

All fellows, but particularly senior fellows, will be encouraged to educate medical students, resident physicians, other allied health personnel, and patients. These teaching activities will be observed by faculty whenever practical so that feedback can be relayed to the fellow.

Books and Reading Materials

Textbook.
Brenner and Rector’s the Kidney. 8th Edition.  Chapter 28. Interventional Nephrology
W.B. Saunders Company.  Maya, ID, Allon M, Saddekni S, and Warnock D.

Websites
ASDIN. American Society of Diagnostic and Interventional Nephrology.http://www.asdin.org
Association of Vascular and Interventional Radiology. www.avir.org

Journals

  • Seminars in Dialysis
  • Journal of Interventional Vascular Radiology