FNB Paediatric Nephrology: Check out NBE released curriculum

Knowledge



To understand the role, limitations and interpretation of commonly used imaging modalities



To know the practicalities and safety precautions associated with each test

Skills



To request the different radiological investigations



To be able to interpret scan images

Skills, Knowledge

 To appropriately request & interpret investigations for assessment of

a. GFR from height and plasma creatinine

b. Calcium, phosphate & bone

mineral metabolism

c. Urinary concentrating and diluting ability

d. Tubular handling of fluid and electrolytes

e. Acid-base balance

 To understand the practicalities, limitations and precautions for measurement of:

a. Creatinine clearance

b. Protein and calcium excretion

c. Tubular handling

d. Tests for urinary acidification

Knowledge



To know the indications, procedure and complications

Skills



To perform a kidney biopsy safely



To recognize common histological appearances and consequences for diagnosis, prognosis and treatment

Knowledge



To understand the epidemiology, clinical

features and issues in diagnosis



Role of imaging, other investigations and therapy



To understand the options/management of UTI &

VUR

Skills



To perform an MCU

Knowledge



To know the presentations of developmental variants and abnormalities, including obstruction



To be aware of different reconstructive procedures

Skills



To be able to provide medical support to urological services

Knowledge



To know the common renal and non-renal diagnoses associated with enuresis



Understand the appropriate use of urodynamic studies and instigate management strategies

Skills



To appropriately assess a child with bladder dysfunction



To interpret Urodynamic studies

Knowledge



To understand the pathophysiology and etiology of macroscopic and microscopic hematuria

Skills



To be able to perform urinalysis



To demonstrate appropriate investigation and management of the child with hematuria, including role of imaging, urological assessment, renal biopsy and genetic and molecular studies

Knowledge



To know and differentiate between physiological and pathological causes of proteinuria



To know the methods of investigation, indications for biopsy; and management of a child with proteinuria

Knowledge



To know the etiology and immunological basis of glomerulonephritis



To know the different forms of presentation and their appropriate management



To understand the clinical course and prognosis of acute and chronic glomerulonephritis



To know the indications for immunosuppressive agents, cytotoxic drugs, plasmapheresis and dialysis

Knowledge



To know the pathophysiology of nephrotic syndrome



To understand the investigation of nephrotic syndrome including indications for renal biopsy



To know the pharmacology and side-effects of steroids, other immunosuppressive agents and other agents

Skills



To detect and manage associated complications



To manage the initial presentation of nephrotic syndrome



To manage steroid-sensitive, steroid-dependent & steroid-resistant nephrotic syndrome, including indications and choice of treatment



To be able to manage congenital nephrotic syndrome

Knowledge



To understand the classification, clinical course and treatment options in lupus nephritis

Skills



To perform clinical examination, plan and interpret investigations, including histology & immunology

Knowledge



To know the causes, presentation, patterns of multisystem involvement and spectrum of disease



To describe the investigation and monitoring of the patient with vasculitis



To list the different therapeutic options available, including adverse effects

Skills



To be able to appropriately investigate and treat vasculitis, including use of immunosuppression

Knowledge



To understand its pathophysiology epidemiology

&



To know the presentation and clinical course of diarrhea-positive and atypical HUS



To understand principles of treatment, role of plasma exchange and dialysis, and long-term management

including implications for transplantation

Skills



To be able to investigate, diagnose and manage the initial presentation of HUS

Knowledge

To list causes of interstitial nephritis/ tubulointerstitial disease

Skills

To appropriately investigate and manage the child

with interstitial nephritis, including use of corticosteroids

Knowledge



To define & understand the diagnosis of hypertension; know the common conditions in different age groups



To describe the possible mechanisms causing essential and secondary hypertension



To describe the investigations in these cases



To describe the mechanism of action and side- effects of anti-hypertensive agents

Skills



To be able to investigate a child with hypertension



To be competent in management of

hypertensive emergencies



To be competent in the management of chronic hypertension, and in using various drugs



To interpret Ambulatory Blood Pressure monitoring

Knowledge



To know the etiology of renal stone formation, including underlying tubular abnormalities



To know the biochemical and radiological investigations



To understand the medical (including prevention of stones) and surgical management

Skills



To demonstrate ability to appropriately

investigate the child with renal stones



To manage the child with renal stones

Knowledge



To understand the causes and different presentations of primary and secondary tubular disorders



To understand the investigation of tubulopathies

Skills



To be competent in the investigation and management of tubular disorders

Knowledge



To list the different causes of renal cystic disease in different age groups



To describe the mode of inheritance and methods of screening, including for multicystic dysplasia



To know the clinical course of polycystic kidney disease, nephronophthisis

Skills



To examine and investigate the child with renal cysts in different age groups



To manage a child with cystic kidney disease

Knowledge



To know the presentation and management of common inherited renal disease including renal involvement in syndromes, familial nephritis and cystic kidney disease



To understand basic genetic principles

Skills



To be able to advise parents of the risk of recurrence and the need for family screening

Knowledge



To understand the physiology of fluid and electrolyte imbalance



To know the principles of treatment of fluid and electrolyte imbalance



To know the endocrine diseases associated with imbalance

Skills

To be able to manage fluid and electrolyte

imbalances in non-renal disease including overdose

Knowledge



To know the differential diagnosis of AKI



To know the investigation including role of biopsy



To describe the methods to correct fluid/biochemical abnormalities and indications for dialysis



To know the treatment of reversible causes of AKI

Skills



To perform a reliable and accurate clinical assessment of the patient’s fluid status



To be able to appropriately manage the complications of AKI – conservative and dialysis



To be able to select and practically manage the different dialysis modalities including peritoneal dialysis, hemodialysis and hemofiltration



To be able to begin treatment of the underlying cause



To manage the patient with multiorgan failure or systemic disease requiring renal replacement therapy

Knowledge



To know the epidemiology, causes of CKD



To know the investigations required in a child with new presentation, including assessment of the degree of renal failure and reversibility of the condition



To understand the natural history and prognosis of common diseases causing CKD, and treatment

strategies that may ameliorate the condition



To understand factors involved in failure to thrive



To describe the pathophysiology, investigation and indications for treatment in mineral bone disease



To describe the pathophysiology of renal anemia, its investigation and appropriate management

Skills



To identify/appropriately manage the underlying cause



To diagnose and treat the child with CKD including biochemical disturbance, bone disease and anemia



To appropriately counsel the family to facilitate the selection of dialysis modality and prior to referral for renal transplantation



To make an accurate assessment of nutritional status & use appropriate advice with the assistance of dietitians



To show ability to prevent, diagnose and manage mineral bone disease

Knowledge

Pre-Transplantation

• To understand the ethical issues surrounding organ donation/ transplant; principles of recipient selection, indications and contraindications

• To know what is involved in a transplant work- up

Transplantation

• To know the basic surgical procedures involved  To know the medications used, including side- effects

Post-Transplantation

• To know the indications for renal transplant biopsy

• To understand the immune mechanisms of rejection, know the recurrence rate of disease & complications

Skills

Pre-transplantation

• To assess the suitability of a patient, discuss issues of transplantation

Post-transplantation

• To be able to manage the stable transplant patient

• To be able to advise the child, family and school

Knowledge



To describe the principles of hemodialysis & compare & contrast with other methods



To describe the methods of vascular access, and their complications



To list the complications occurring during dialysis

Skills



To be able to plan the initiation of hemodialysis



To manage different forms of vascular access



To adjust the prescription, manage

complications of hemodialysis

the

Knowledge



To describe the principles of acute and chronic dialysis, & the advantages/disadvantages compared to hemodialysis



To know the complications of peritoneal dialysis, both infective and mechanical

Skills



To be able to prescribe/monitor patients on dialysis



To manage the complications of peritoneal dialysis

Knowledge



To define principles of pharmacokinetics and drug handling in renal impairment



To list ways in which different classes of drugs act on the nephron and affect renal function



To list the effects of hemodialysis, hemofiltration and peritoneal dialysis on drug prescribing



To describe principles of drug interactions, especially immunosuppressive agents

Skills



To prescribe safely to patients with renal disease