Presentations
- Acute kidney injury/disease
- Allergic presentation with fever and rash
- Hypertension
- Nephritic syndrome
- Nephrotic syndrome
- Proteinuria/haematuria +/- oedema
- Rapidly progressive GN
Conditions
- Diabetic kidney disease
- Glomerular disease:
- ANCA-associated vasculitis
- anti-glomerular basement membrane disease
- focal segmental glomerulosclerosis
- Henoch–Schönlein purpura (HSP)
- lupus nephritis
- membranous nephropathy
- minimal change disease
- post-infectious glomerulonephritis
- thin basement membrane nephropathy
- complement-related GN:
- C3 GN, atypical hemolytic-uremic syndrome (HUS)
- pregnancy-related disorders:
- haemolysis, elevated liver enzymes and low platelets (HELLP)
- pre-eclampsia (PET)
- Paraprotein-related kidney disease, including:
- disorders amyloid, myeloma, monoclonal gammopathy of kidney significance (MGRS)
- fibrillary and immunotactoid glomerulonephritis
- cryoglobulinemic glomerulonephritis
- Tubulointerstitial nephritis (acute/chronic):
- drugs/toxins
- granulomatous
- hemoglobinopathy
- immune
- infections
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 relevant 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
Manage
- provide evidence-based management For less common or more complex presentations and conditions the trainee must also seek expert opinions
- 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
Conditions
- Fabry disease
- Immunoglobulin G4 (IgG4) disease
- Infections including:
- Rare vasculitides:
- Kawasaki disease
- Polyarteritis nodosa (PAN)
- Takayasu's arteritis (TA)
- Sarcoidosis
- Scleroderma kidney disease
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 relevant 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
Manage
- provide evidence-based management For less common or more complex presentations and conditions the trainee must also seek expert opinions
- 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
- Aetiology, pathology and clinical manifestations of glomerulonephritis, proteinuria, and haematuria
- Basics of the immune system, including immune system regulation and the relationship to nephritis
- Genetics associated with GN, such as thin membrane nephropathy
- Pathophysiology of interstitial nephritis and tubulo-interstitial disease, their causes, and links with systemic disease
- Systemic diseases with renal involvement including infection
Imaging
- Ultrasound
- CT
- MRI
- Nuclear scans
Laboratory tests
- Complement levels
- Cryoglobulins
- Disease-specific auto-antibodies
- Genetic studies
- Kidney biopsy
- Serum electrophoresis
- Urinalysis and urine microscopy:
- spot urine and timed urine in the assessment of glomerular and tubular proteinuria (UACR, UPCR)
- Evolving treatments/high-cost treatments of glomerular and tubulo- interstitial diseases
- Need for rapid diagnosis in most rapidly progressive GN and thrombotic microangiopathies
- Pharmacology and monitoring of the use of immunosuppressive drug classes, including drugs modulating complement
- Supportive treatments including:
- diet
- lipid lowering diuretics
- renin-angiotensin-aldosterone system inhibitors (RAASi)
- salt and potassium restrictions
- treatments directed towards nephrotic syndrome, e.g. anticoagulation
- The role of plasma exchange
PCH
- Common lesions causing nephrotic syndrome in children, including:
- diffuse mesangial sclerosis focal segmental glomerulosclerosis (FSGS)
- glomerulonephritis (GN)
- manage immunosuppression, diuretics, ACEI/ARB, statins
- membranoproliferative
- minimal change disease
- systemic lupus erythematosus (SLE)
- Congenital nephrotic syndrome
- Referral for genetic studies
- The impact of steroids on growth and behaviour, including educational impact, and therefore the need for steroid sparing agents
- The pathogenesis, clinical considerations, management, and prognosis of children with: Henoch-Schönlein purpura post-infectious GN rapidly progressive GN
