7.4. Nephrology 1600-LekM4CNMNEF-J

Classes in nephrology are conducted in the form of seminars and exercises. The aim of the seminars is to familiarize students with the issues of epidemiology, pathophysiology as well as diagnostics and pharmacotherapy of nephrological syndromes such as: acute kidney injury, chronic kidney disease, primary and secondary glomerulonephritis, as well as tubulointerstitial nephritis, nephrolithiasis and complications of these entities sickness. The curriculum also covers the diagnosis and treatment of arterial hypertension and basic disorders of water, electrolyte and acid-base balance. The exercises are devoted to improving the practical skills of an internal medical history and physical examination of a patient, with particular attention to systemic symptoms occurring in the course of kidney diseases, including the assessment of the body's water balance, correct blood pressure measurement and the interpretation of additional laboratory and imaging tests. The problems of diagnosis, differential diagnosis and treatment of: nephrotic and nephritic syndromes, acute kidney damage, chronic kidney disease and arterial hypertension are also discussed during the exercises. Students learn to interpret the results of additional tests in relation to the listed disease entities. They assist in diagnostic and therapeutic procedures, such as kidney biopsy, and central venous hemodialysis catheter implantation. During the exercises, dialysis techniques (hemodialysis, peritoneal dialysis) and vascular accesses for renal replacement treatment (temporary and tunneled catheter) are presented and discussed. Students are acquainted with the issues of renal replacement therapy for urgent and chronic indications and with the assessment of the adequacy of dialysis therapy.

Seminar topics
1. Basics of kidney disease diagnostics - evaluation of glomerular filtration
2. Proteinuria, nephritic and nephrotic syndrome, kidney biopsy
3. Polycystic kidney disease
4. Renal anemia
5. Basics of kidney disease diagnostics – symptoms of kidney disease, urinalysis
6. The diagnosis of arterial hypertension
7. Hypotensive drugs and principles of treatment of arterial hypertension
8. Reno-vascular hypertension
9. Acute and rapidly progressive glomerulonephritis
10. Chronic glomerulonephritis
11. Drug nephrotoxicity
12. Rare diseases of the kidney (HUS, thrombotic microangiopathy, amyloidosis)
13. Disorders of water balance
14. Disorders of sodium balance (hypo- and hypernatremia)
15. Disorders of potassium balance (hypo- and hyperkalemia)
16. Disorders of acid-base balance
17. Hematuria – causes and diagnostics
18. Nephrolithiasis (kidney stone disease)
19. Acute kidney injury
20. Peritoneal dialysis
21. Urinary tract infections - causes, diagnosis, treatment
22. Interstitial nephropathies
23. Diabetic nephropathy
24. Chronic kidney disease (CKD)
25. Hemodialysis
26. Vascular access in hemodialysis
27. Disorders of calcium and phosphate metabolism in CKD
28. Principles of qualifying patients for kidney transplantation

Exercise topics include the following:
1. A patient with acute kidney injury.
2. Patient with chronic kidney disease.
3. Patient with nephrotic / nephritic syndrome.
4.Patient undergoing renal replacement therapy with hemodialysis or peritoneal dialysis.
5. Patient with urinary tract infection.
6. Patient with arterial hypertension.
7. Patient with water-electrolyte and acid-base disorders.