Nephrology Fellowship -
Clinical Training & Education
Typically, most first-year fellows serve on the inpatient nephrology and hypertension consultation service and inpatient transplant service, although some serve in an ambulatory care setting. Fellows also attend two half-day ambulatory clinics throughout the year, irrespective of what rotation they are on.
While exposure to acute hemodialysis is ample in the first year, exposure to chronic hemodialysis and peritoneal dialysis is limited.
The second year provides ample experience in chronic (outpatient) hemodialysis and peritoneal dialysis through Cincinnati Department of Veterans Affairs (VA) Medical Center and/or University Hospital Outpatient HD Unit, and the offsite, freestanding outpatient dialysis unit.
The renal consultation service sees approximately 600 nephrology referrals annually within University Hospital system and VA Medical Center.
Fellows see all new consults and provide the initial assessment, followed by discussions with the consult attending. This provides intensive experience in the supervised management of patients with a broad range of renal problems, acid-base and electrolyte management, acute hemodialysis including continuous therapies and performance, and interpretation of renal biopsies.
The fellow shares teaching responsibilities with the rotating residents and medical students.
The University Hospital transplant service performs approximately 60 renal and 15 pancreas transplants per year. The UC Division of Nephrology and Hypertension works closely with the transplant surgery service and three nephrologists fully committed to transplantation.
The transplant rotation provides extensive experience in patient selection, medical management of transplant recipients and renal allograft biopsy and interpretation.
We have an Interventional Nephrology Program, which includes clinical and research components. All fellows will rotate through this program.
Both University Hospital and Cincinnati VA have a 10-station acute dialysis unit.
The UC Division of Nephrology and Hypertension operates two free-standing ambulatory dialysis centers that include a 28-station hemodialysis unit and a two-station peritoneal dialysis home training unit within several blocks of the medical campus and two 12-station hemodialysis satellite units three and 10 miles, respectively, northwest of the medical campus.
Currently, we care for approximately 400 dialysis patients of whom 15 percent are at home, mostly on CAPD.
In addition to the above services, the division operates a nephrology-hypertension outpatient clinic with more than 1,000 annual visits, a transplantation clinic with 2,900 visits and a renal-hypertension clinic with approximately 2,000 visits.
The hypertension section is actively engaged in genetic hypertension research and clinical drug trials, providing comprehensive care to patients with complicated hypertension by evaluating risk factors and developing long-term treatment plans.
Cincinnati VA nephrology clinic has approximately 1,000 visits annually, and fellows participate in all of these outpatient services.
Our program is integrated with the pediatric nephrology program at Cincinnati Children's Hospital Medical Center for education, research and patient care. Our fellows have the opportunity to rotate through Cincinnati Children's; night call is taken at University Hospital during that month.
Weekly teaching conferences include a clinical conference, a research conference and a core lecture series. An additional session is devoted weekly to NephSap and Brenner and Rector Physiology chapter reviews.
The division also organizes a monthly biopsy conference and a monthly journal club that are primarily coordinated by the fellows.
The departments of pediatric nephrology, urology and radiology organize optional clinical conferences, while the division faculty members and departments of physiology and biophysics, molecular genetics, biochemistry and microbiology, and pharmacology and cell biophysics provide a wide variety of basic science seminars.
The University of Cincinnati Academic Health Center includes University Hospital, which has 695 beds; the adjacent Cincinnati Department of Veterans Affairs Medical Center with 116 beds; and Cincinnati Children's with 330 beds.