08793 - Nephrology

Learning outcomes

The course aims to provide students with the fundamental theoretical and professional knowledge required for the prevention, diagnosis, and treatment of the major primary and secondary kidney diseases, as well as related syndromes, including the principal disorders of fluid, electrolyte, and acid–base homeostasis.

The course is designed to promote a sound methodological and scientific approach to nephrology by strengthening students’ knowledge base, critical thinking skills, and multidisciplinary approach to renal diseases and nephrological disorders.

Topics covered will include prevention, epidemiology, pathogenesis, histopathological and morphological characterization, the clinical significance of laboratory investigations, differential diagnosis, and the pharmacological and therapeutic management of kidney diseases, with the goal of developing appropriate clinical decision-making skills aimed at preventing potential complications.

The educational pathway will address the full spectrum of renal diseases, including chronic kidney disease and its management across community and healthcare settings, acute kidney injury, dialysis, and kidney transplantation.

By the end of the course, students will have acquired essential knowledge of the major nephrological disorders, as well as the biochemical, instrumental, and clinical investigations required for diagnosis, together with an introduction to therapeutic strategies in the four main areas of nephrology:

1. Disorders of fluid, electrolyte, and acid–base balance;
2. Clinical and diagnostic nephrology;
3. Dialysis;
4. Kidney transplantation.

Through participation in structured clinical placements that provide practical experience in all four areas, students will also develop the theoretical and practical foundations necessary for the recognition and management of nephrological diseases. They will learn to evaluate symptoms, clinical signs, laboratory and instrumental findings, and prognostic factors, thereby acquiring the competencies required for an integrated diagnostic and therapeutic approach to patients with kidney disease.

Course contents

Reminder of anatomy and physiology

Nephrological semiotics (clinical, laboratory tests, diagnostic imaging, renal biopsy)

Major electrolyte disorders.

 

Approach to glomerular diseases: classification and pathogenic mechanisms.

 

Nephrotic syndrome: podocytopathies (minimal change disease, focal segmental glomerulosclerosis, membranous nephropathy).

 

Nephritic syndrome: post-streptococcal glomerulonephritis and IgA nephropathy.

 

Rapidly progressive glomerulonephritis: ANCA-associated vasculitis and anti-glomerular basement membrane (anti-GBM) disease.

 

Secondary glomerular diseases: lupus nephritis, diabetic kidney disease, hypertensive nephropathy, and renal involvement in plasma cell dyscrasias.

 

The role of the complement system and the major complement-mediated kidney diseases.

 

Inherited kidney diseases: autosomal dominant polycystic kidney disease, Alport syndrome, and Fabry disease.

 

Tubulointerstitial nephropathies: acute pyelonephritis, chronic pyelonephritis, and immune-mediated allergic interstitial nephritis.

 

Acute kidney injury: clinical manifestations and diagnostic evaluation.

 

Chronic kidney disease: diagnosis, classification, conservative management, and associated complications (anemia, mineral and bone disorders, and cardiovascular disease).

 

Kidney replacement therapies: hemodialysis (in-center and home hemodialysis) and peritoneal dialysis.

 

Kidney transplant: living-donor and deceased-donor transplantation, including challenges, complexities, and critical issues.

Readings/Bibliography

Garibotto–Pontremoli, Manuale di Nefrologia, Minerva Medica.
A contemporary textbook that, together with the educational material provided during the lectures, offers a solid foundation for the study and understanding of nephrology.

Johnson RJ, Floege J, Tonelli M. Comprehensive Clinical Nephrology. 7th Edition. Elsevier; April 5, 2023.

Brown RS. Clinical Handbook of Nephrology. 1st Edition. Elsevier; August 1, 2023.

Additional and updated teaching materials will be provided throughout the course.

Teaching methods

Student learning will be assessed through an oral examination.

During the examination, students may be asked to:

• Discuss and evaluate a clinical case by analyzing the main signs and symptoms, formulating the relevant differential diagnoses, and discussing appropriate therapeutic options.
• Describe and compare different manifestations of kidney diseases. Assessment will take into account the student’s ability to understand the underlying pathophysiological mechanisms and to apply sound diagnostic reasoning.

Students will also be evaluated on their ability to present and discuss topics clearly, accurately, and using appropriate medical terminology.

 

Assessment methods

At least 3 in-presence exam sessions

Teaching tools

Updated teaching material provided during the course in PDF format available on "virtuale"

Office hours

See the website of Olga Baraldi

See the website of Lilio Hu