Presentations
- Assess for kidney scarring
- Assess for the presence of clinically significant renovascular hypertension
- Quantify differential kidney function
- Suspected kidney outflow tract obstruction
Conditions
- Kidney failure
- Kidney lesions requiring resection
- Kidney tract infection
- Kidney transplant
- Renovascular hypertension
- Urinary tract dilatation
PCH
- Congenital anomalies of the renal tract
- Hydronephrosis and/or hydroureter
- Renal cortical scarring
- Urinary tract infection / pyelonephritis
- Vesico-ureteric reflux
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Presentations
- Quantify glomerular filtration rate in vivo
Conditions
- Unexpected results on serum eGFR, for quantification such as unexpectedly high or low eGFR
PCH
- Acute kidney failure
- Kidney transplantation
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients’ needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Anatomy and physiology
- Anatomical relations of the bladder, kidneys, and ureters in the abdomen and pelvis, and common variants
- Embryology and anatomy of the bladder, genital tracts, kidneys, and ureters
- Kidney mechanisms involved in blood volume and blood pressure, and the effects of diuretics on these mechanisms
- Physiological changes induced by acute and chronic kidney failure
- Physiological processes of glomerular filtration, kidney blood flow, urine formation, and their control
- Tubular processing of glomerular filtrate
Kidney imaging radioisotopes and imaging protocols
- Different kidney imaging radiopharmaceuticals and their benefits / limitations in relation to assessment of kidney function and physiology
- Diuretic renography
- Methods of quantitation that can be used in kidney studies and their limitations
- The role of post-void images and gravity-assisted drainage
- Timing of kidney cortical imaging studies to episodes of known or suspected infection
- Use of angiotensin converting enzyme (ACE) inhibitor protocol, including identifying when to use it, how to prepare the patient, and when to administer to maximise the diagnostic accuracy of the study
Pathophysiology
- Acute epididymitis and testicular torsion
- Acute kidney failure, including acute tubular necrosis (ATN) and acute cortical necrosis
- Acute pyelonephritis and kidney scarring
- Chronic kidney disease, including kidney failure
- Renovascular hypertension (RVH)
- Transplant rejection
- Types of urinary tract obstruction
- Vesicoureteric reflux
PCH
- Embryology and the impact on kidney tract anomalies
- Pathophysiology of paediatric kidney disease, including infection and subsequent kidney damage
Investigations
- Glomerular filtration rate (GFR) analysis
- Kidney scintigraphy:
- evaluation of disruption of normal kidney physiology in native and transplant kidneys
- evaluation of kidney cortical defects:
- pinhole imaging
- SPECT and/or SPECT / CT imaging
- evaluation of outflow tract obstruction:
- diuresis renography protocols
- isotopes appropriate to kidney function and their differences
- quantitation parameters
PCH
- Dynamic renal scan with diuretic administration
- GFR
- Radionuclide cystograms
- Renal cortical scintigraphy
- Appropriate patient preparation for patients undergoing kidney scintigraphy for renovascular hypertension
- Identify which ACE inhibitor to administer prior to the radiopharmaceutical, the dose, and the timing between administration of ACE inhibitors and commencement of scintigraphy
- Patient demographics, including geographic location, socioeconomic status, ethnicity, and cultural background, and the considerations when managing and following up these patients, such as travel from rural to metropolitan areas
- Radiation protection, patient safety and consent
- Radioisotope decay and patient proximity to therapy / examination
- Timing, advantages, and limitations of investigations and procedures
PCH
- Normal kidney growth and development
- Patient age and the impact on kidney function and image interpretation
