Students in the Nephrology Fellowship Program at Lankenau Medical Center will be extensively prepared to identify and treat a wide range of nephrologic conditions in both in-patient and out-patient settings. Because the field of nephrology is integrative in nature, fellows will gain experience in renal anatomy, physiology, pathophysiology, pharmacokinetic issues and renal replacement therapy, including dialysis and transplantation.
These skills will be learned through lectures, conferences, clinical experience and rotations. Fellows will also have experience with the following:
Inpatient Clinical Nephrology
Acute renal failure and chronic renal failure — its management by conservative methods, including nutritional management of uremia.
Hypertension (primary and secondary)
Diabetes mellitus, vasculitis and connective tissue diseases.
Glomerular and tubulo-interstitial diseases as well as the cystic diseases of the kidney.
Both nephritic and nephrotic processes
Acid base and electrolyte disorders including divalent ion disorders
Nutritional assessment and multiple methods for calculating creatinine clearance and GFR
Transplant immunology, transplant therapy including immunosuppressant and steroid therapy, histo-compatibility testing and tissue typing
Techniques of kidney harvesting, donor retrieval and recipient implantation
Short-term and long-term transplant complications including rejection
Social and economic, as well as ethical, issues complicating the renal transplantation environment
Proper design, methodologic development and statistical evaluation and comprehension
The completion of a comprehensive abstract and/or original manuscript
Technical and Procedural Skills
The fellow is expected to study and experience the performance of indications, complications, interpretation of results, cost effectiveness and application to patient care of the following:
Biopsy of both autologous and transplanted kidneys
Placement of temporary vascular access for hemodialysis and related procedures
Acute and chronic hemodialysis
Continuous renal replacement therapy
Other Areas of Focus
The following areas of nephrology knowledge should be reviewed and developed in order to acquire expertise in the prevention, evaluation and management of the following disorders:
Disorders of mineral metabolism and nephrolithiasis and renal osteodystrophy
Disorders of fluid, electrolyte and acid-base regulation
End Stage Renal Disease
Renal disorders of pregnancy
Urinary tract infections
Disorders of drug metabolism and renal drug toxicity
Genetic and inherited renal disorders
Geriatric aspects of nephrology including disorders of the aging kidney and urinary tract
Renal transplantation including...
Evaluation and selection of transplant candidates
Pre-operative evaluation and preparation of transplant recipients and donors.
Immediate postoperative management of transplant recipients including administration of immunosuppressants
Clinical diagnosis of all forms of rejection including laboratory, histopathologic and imaging techniques
Medical management of rejection, including use of immunosuppressant drugs and other agents
Recognition and medical management of the surgical and non-surgical complications of transplantation
Long-term follow-up of transplant recipients in the ambulatory setting
Dialysis and extracorporeal therapy, including...
Evaluation and selection of patients for acute hemodialysis or continuous renal replacement therapies
Evaluation of ESRD patients for various forms of therapy and their instruction regarding treatment options
Drug dosage modification during dialysis and other extracorporeal therapies
Evaluation and management of medical complications in patients during and between dialysis and other extracorporeal therapies
Long-term follow-up of patients undergoing chronic dialysis including dialysis prescription and modification and assessment of adequacy of dialysis
An understanding of the principals and practice of peritoneal dialysis including peritoneal access, principals of dialysis catheters and how to chose appropriate catheters
An understanding of the technology of peritoneal dialysis including automated cyclers
Assessment of peritoneal dialysis efficiency using peritoneal equilibration testing (PET) and the principals of peritoneal biopsy
The pharmacology of commonly used medications and their kinetic and dosage alteration with peritoneal dialysis
An understanding of complications of peritoneal dialysis including peritonitis and its treatment, exit site and tunnel infections and their management, hernias, pleural effusions and other less common complications and their management
A understanding of the special nutritional requirements of patients undergoing hemodialysis and peritoneal dialysis
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Graduate Medical Education
Main Line Health
100 East Lancaster Avenue
Wynnewood, PA 19096
For more information, call 1.866.CALL.MLH.