Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Acute oligo-anuria
- Fever in renal transplant recipients
- Oedema
Conditions
- Acid-base imbalance
- Acute and chronic glomerulonephritis, including:
- nephritic syndromes
- rapidly progressive glomerulonephritis
- Acute kidney injury, including acute tubular necrosis
- Chronic kidney disease (CKD)
- Diabetic nephropathy
- Drug-related nephrotoxicity
- Electrolyte abnormalities
- hypo- and hypercalcaemia
- hypo- and hyperkalaemia
- hypo- and hypernatraemia
- End-stage renal failure
- delaying progression of CKD
- initiating chronic dialysis
- modes of dialysis, haemodialysis and peritoneal dialysis
- Hypertension
- Nephrotic syndrome
- Urosepsis and pyelonephritis
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, 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 patients1 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
Less common or more complex presentations and conditions
Basic Trainees will understand these presentations and conditions. Basic Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Conditions
- Chronic renal failure, including:
- anaemia
- complications of dialysis
- mineral and bone disorder
- Inherited and genetic renal disease, such as:
- Alport syndrome
- polycystic kidney disease
- Renal artery stenosis
- Renal calculus disease and obstructive uropathy
- Renal hypertension
- Renal manifestations of systemic and chronic disease
- Tubulo-interstitial kidney disorders
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, 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 patients1 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
Epidemiology, pathophysiology and clinical sciences
Basic Trainees will describe the principles of the foundational sciences.
- Acid-base regulation and its link to the respiratory system
- Measurement of renal function and estimation of glomerular filtration rate (eGFR) using creatinine clearance
- Normal urine composition
- Pharmacology of major drug classes used to treat kidney disease
- Prescribing in kidney disease
- Principles of renal replacement therapies:
- haemodialysis and peritoneal dialysis
- transplantation
- Process of fluid and electrolyte status regulation
- Process of hormonal regulation:
- aldosterone and its link to the endocrine system
- antidiuretic hormone (ADH)
- renin-angiotensin system (RAS)
- Renal disease and anaemia
- Structure and function of the renal system and prostate
Investigations, procedures and clinical assessment tools
Basic Trainees will know the indications for, and how to interpret the results of these investigations, procedures, and clinical assessments tools. Basic Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Investigations
- Imaging:
- functional renal scans
- renal angiogram
- renal tract ultrasound
- urograms
- Laboratory tests:
- arterial blood gases (ABGs)
- electrolytes
- full blood count (FBC)
- haematuria
- proteinuria
- renal function
- urinalysis
- Renal biopsy
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- Indications for acute and chronic dialysis
- Referral for vascular access where appropriate
- Renal transplantation issues:
- immunosuppression, including drug interactions
- importance of anticipating future need for dialysis or transplant in patients with progressive CKD
- principles of assessment of potential donor transplant candidates and their understanding of the risks of transplantation
- short and long-term complications, including management of BK virus nephropathy, diarrhoea, and neutropenia
- Management of the patient with CKD in palliative care
- References to patients in the remainder of this document may include their families or carers.