08793 - Nephrology

Learning outcomes

This course aims to provide students with the essential theoretical and practical knowledge needed for the prevention, diagnosis, and treatment of major primary and secondary kidney diseases. It also covers related conditions, including disorders of fluid balance, electrolytes, and acid-base regulation.

The course will help students develop a structured and multidisciplinary approach to nephrology by strengthening their understanding, critical thinking, and clinical reasoning skills.

Main topics include prevention, epidemiology, disease mechanisms, tissue and morphological features, interpretation of laboratory tests, differential diagnosis, and available treatments. The course also focuses on developing decision-making skills to help manage complications effectively. Students will study key areas such as chronic kidney disease (including its impact at the community level), acute kidney injury, dialysis, and kidney transplantation. By the end of the course, students will have a clear understanding of the main nephrological conditions, the diagnostic tools used (biochemical, instrumental, and clinical), and an overview of treatment options in four core areas: 1) disorder of fluid, electrolyte, and acid-base balance, 2) clinical diagnosis, 3) dialysis, 4) kidney transplantation. Participation in structured clinical internships will give students practical experience in these four areas, enabling them to recognize and manage kidney diseases by evaluating symptoms, clinical signs, lab and imaging results, and potential outcomes.

Course contents

The course is designed to equip students with a comprehensive and progressive understanding of renal pathophysiology and the key clinical conditions encountered in nephrology. Emphasis is placed on developing the ability to critically evaluate clinical and laboratory data and to formulate coherent diagnostic and therapeutic strategies.

Anatomy and Physiology of the Kidney and Urinary Tract

 Detailed study of the structural and functional aspects of the urinary system, focusing on glomerular filtration, tubular reabsorption and secretion, fluid and electrolyte homeostasis, and blood pressure regulation. These fundamentals are essential for understanding renal disease mechanisms.

Principles of Nephrological Clinical Examination and Diagnostic Approach to Nephropathies

 Assessment of nephrology-relevant signs and symptoms (e.g., edema, hypertension, alterations in urine output), interpretation of laboratory tests and imaging studies (urinalysis, proteinuria, serum creatinine, renal ultrasound), and a structured approach to differential diagnosis.

Disorders of Fluid and Electrolyte Balance

 Clinical presentation, pathophysiology, and management of common electrolyte disturbances such as hyponatremia, hyperkalemia, and metabolic acidosis, with emphasis on their diagnostic and therapeutic implications.

Glomerular Diseases: Primary and Secondary

 Clinical and pathological overview of glomerulonephritis, including etiology, diagnostic pathways, prognostic factors, and current therapeutic options, highlighting emerging immunosuppressive and biologic treatments.

Cystic and Hereditary Kidney Diseases

 Classification and clinical management of inherited nephropathies, focusing on autosomal dominant polycystic kidney disease and hereditary tubulointerstitial disorders, with consideration of diagnostic challenges and precision medicine approaches.

Urinary Tract Infections

 Diagnosis, classification, and management strategies for urinary tract infections in both outpatient and inpatient settings, with particular attention to complicated, recurrent, and comorbidity-associated infections.

Acute Kidney Injury (AKI)

 Internationally recognized definitions and classifications (KDIGO), early detection strategies, identification of reversible causes, therapeutic interventions, and follow-up protocols for patients with AKI.

Chronic Kidney Disease (CKD)

 Clinical staging, risk factors for progression, conservative management, and prevention of complications. In-depth discussion on anemia related to erythropoietin deficiency, renal osteodystrophy, cardiovascular risk, and coordinated multidisciplinary care.

Renal Replacement Therapies

 Clinical indications and technical principles of hemodialysis and peritoneal dialysis, management of complications, and criteria guiding therapy choice. Overview of kidney transplantation including candidate assessment, perioperative management, immunosuppression, and long-term follow-up.

Renal Function Across the Lifespan

 Clinical considerations for renal physiology and pathology in vulnerable populations such as preterm neonates and elderly patients, with tailored management approaches accounting for comorbidities and frailty.

Readings/Bibliography

Manuale di Nefrologia, Garibotto-Pontremoli, ed. Minerva Medica.

Comprehensive Clinical Nephrology, 7th Edition
By Richard J. Johnson, Jürgen Floege, Marcello Tonelli, Glenn M. Chertow, published by Elsevier.

Updated teaching materials provided during the course.

Teaching tools

Teaching materials in slide format accessible through the Virtual platform of the University of Bologna.

Office hours

See the website of Olga Baraldi