INTERNAL DISEASES- NEPHROLGY AND RHEUMATOLOGY
Nephrology (from Greek nephros, "kidney") is a branch of internal medicine dealing with the study of the function and diseases of the kidney.
Nephrology concerns itself with the diagnosis and treatment of primary kidney diseases including glomerulonephritis and nephrolithiasis and secondary kidney diseases such as diabetic nephropathy and hypertensive nephropathy. Nephrology focuses also on patients requiring renal replacement therapy (haemodialysis and peritoneal dialysis) and renal transplant recipients. Nephrology deals with water and electrolyte disturbances as well.
Many diseases affecting the kidney are systemic disorders not limited to the organ itself, and may require special treatment. Examples include acquired conditions such as diabetic nephropathy, systemic vasculitides and autoimmune diseases (eg lupus erythematosus), as well as congenital or genetic conditions such as polycystic kidney disease.
During nephrology courses students will be training in the diagnosis and medical management of kidney disease - acute kidney injury and chronic renal failure, glomerular and vascular disorders, tubular/interstitial disorders, mineral metabolism, clinical pharmacology, hypertension, treatment of acid-base and electrolyte disturbances, nephrolithiasis (kidney stones), epidemiology and nutrition.
Students get the opportunity to see some diagnostic procedures as native kidney biopsies with ultrasound guidance and therapeutical procedures as placement of temporary dialysis catheters, placement of tunneled hemodialysis catheters and placement of peritoneal dialysis catheters. Students will be taught how to plan and monitor dialysis therapy.
Main problems which nephrology concerns:
§ Acute renal failure, a sudden loss of renal function
§ Chronic kidney disease, declining renal function, usually with an inexorable rise in creatinine
§ Hematuria, blood loss in the urine
§ Proteinuria, the loss of protein especially albumin in the urine
§ Kidney stones, usually only recurrent stone formers
§ Chronic or recurrent urinary tract infections
§ Hypertension that has failed to respond to multiple forms of anti-hypertensive medication or could have a secondary cause
§ Electrolyte disorders or acid/base imbalance
TEACHERS:
dr med. Paweł Stróżecki
dr med. Beata Sulikowska
dr med. Mariusz Flisiński
dr Rafał Donderski
CONTACT: dr Rafał Donderski,
SYLABUS
I. Name of the unit offering the course: Department of Nephrology, Hypertension and Internal Diseases
II. Head of the unit: Prof. dr hab. Jacek Manitius
III. 4th year, number of hours: 62
IV. Form of classes: lectures: 2, seminars: 30, tutorials: 30
VI. Form of crediting: credit with grade
VII. Number of hours: 30 hours of seminars, 30 hours of tutorials
VIII. Aim of the course:
1. A thorough approach to the patient with kidney disease, taking appropriate history and
physical examination and generating appropriate differential diagnosis
2. A thorough understanding of the laboratory and imaging methods used to evaluate
patients with kidney disease
3. Understand the principles of renal physiology and renal pathology, hypertension,
glomerular diseases, diabetic nephropathy, acute renal failure, chronic kidney disease,
dialysis delivery, vascular access.
4. Have a thorough understanding of the principles of hemodialysis, peritoneal dialysis,
continuous renal replacement therapies and manage complications of these therapies.
5. Clinical presentation of most common rheumatological disorders.
IX. Seminars/tutorials topics nephrology
a. Basic diagnostics in kidney diseases.
b. Acute kidney injury (AKI)
c. Chronic kidney disease: definitions, stages, clinical presentation, renal replacement therapy: principles of hemodialysis and peritoneal dialysis.
d. Hematuria
e. Proteinuria
f. Urolithiasis
g. Urinary tract infections (UTI)
h. Primary, secondary, resistant hypertension, anti-hypertensive medication
i. Electrolyte disorders or acid/base imbalance.
j. Renal anemia
k. Bone and mineral disorders in CKD (MBD-CKD)
l. Diabetic kidney disease
m. Acute and chronic tubulointerstitial nephritis
n. Renal diseases in pregnancy
X. Topics of lectures/tutorials/seminars: Rheumatology
a. Lupus erythematosus and antiphospholipid syndrome.
b. Rheumatoid arthritis
c. Sclerodermia
d. Systemic vasculitis
e. Primary and secondary amyloidosis
f. Osteoporosis and gout
g. Spondyloarthritis
h. Spondyloartritides (septic arthritis, Bechterew’s disease, psoriatric arthritis)
XI. Self- study topics: case report presentation of patient admitted to the Clinic during the nephrology/rheumatology course.
XI. Booklist:
basic - Johnson, R. J., Feehally, J. (eds). Comprehensive Clinical Nephrology.
Philadelphia, Elsevier Limited, 2007.
additional - Brenner, B. M., Levine, S. A. (eds). Brenner and Rector’s The Kidney. W.
B. Saunders Company
XII. Detailed list of required practical skills and confirmation of completig:
Assessment of physical examinations skills and interpretation of some laboratory tests, for example urinalysis, acid-base abnomalities, BUN, creatinine ,eGFR, uric acid levels, calcium, phosphorus, potassium abnormalities, water and sodium disorders. Most common lab test in rheumatological diseases. Confirmation of completing – students individual confirmation card.
RULSES AND REGULATIONS