Renal

Rotation Director: Sandra Iragorri

Email: iragorri@ohsu.edu (preferred mode of communication)

Pager: 12731

Phone: 914-772-7301

Office: CDRC 1271

Overview:

Residents spend time with inpatient and outpatient teams to gain exposure to a variety of renal conditions across a spectrum of care.

Rotation goals and objectives:

• Teach residents about the care of infants, children, and adolescents with common renal pathologies, electrolyte derangements, urinary/bladder conditions, and recent kidney transplants.

• The resident will be able to evaluate growth and nutritional issues of patients with chronic kidney disease

Prior to the start of the rotation:

• Receive sign-out from previous resident about both consult and primary renal patients. This should include active issues, current interventions, and overall patient status.

First day of the rotation:

• Arrive to 10N workroom (behind giraffe) with ample time to pre-round on active patients (usually 0730-0800).

• Attend morning teaching

• Meet with nephrology attending at 0900 in 10N workroom. Note: some attendings round on ICU patients prior to morning teaching. Please discuss the current census and expectations with the outgoing resident to help better plan your first morning.

Resident Expectations:

• Active and contributing member to inpatient/outpatient team. This could include pre-rounding and/or pre-clinic review of patient charts, asking pertinent questions during rounds, and taking thorough histories regardless of setting

• Completing all daily clinic and consult notes on same day

• Timely assessment and workup of new consults

• Attend renal clinic AT LEAST twice weekly (or 6 total times over the block)

• Continuity clinic ½ day per week

• Complete and review problem set with Sandra Iragorri*

• Plan a 15 minute presentation for the end of the rotation*

General Schedule:

A. Inpatient Experience

• See new consults and follow old consults for continuity. Must arrive in time to preround on all active consults (usually 0730-0800)

• Attend daily SSB and renal rounds in 10N workroom

• Attend procedures for inpatients (eg renal biopsy)

• May leave in afternoon after all new and active consults seen, assessed, and discussed

B. Outpatient experience: Schedule for outpatient nephrology clinics is as follows…

• Monday all day

• Tuesday AM Transplant Clinic

• Thursday all day

• Friday PM

C. Important meetings:

• Nephrology attending group meeting 1300-1430 on Tuesdays

• (Occasional) Biopsy meeting 1200-1300 on Fridays

• (Rare) Nephrology-Urology joint conference ***when

D. Conference

• You should ALWAYS attend grand rounds, morning report, noon conference and Friday Forum

If you are going to be absent for all or part of a day:

Please email attending on service, chief on call, and Michael Grubbs if you are unable to make it to work.

Any resident missing more than 2 days (or 4 half days) may be required to make up the difference at a future date at the discretion of the rotation director, chiefs, and program leadership.

Resident Resources, Helpful Tips, and Further Readings:

1) American Board of Pediatrics Content

A. Renal physiology (eg, acid-base balance, electrolytes)

B. Clinical presentation (eg, hematuria, protienuria, polyuria)

C. Diseases, disorders, and conditions

1. Inflammatory

2. Dysfunctional

3. Genetic

D. Renal transplant

2) The problem set as well as many pertinent articles and readings found here on box

3) Pertinent textbooks: Pediatric Nephrology by Holiday Barrat or Geary Schaefer