Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Daytime and night-time wetting
- Genitourinary trauma
- Haematuria
- Proteinuria:
- nephrotic syndrome
- orthostatic
- transient
Conditions
- Acid–base and electrolyte disturbances
- Acute kidney injury
- Congenital anomalies of the kidney and urinary tract:
- antenatal diagnosis
- urinary obstruction
- vesicoureteral reflux (VUR)
- Developmental abnormalities of the external genitalia:
- ambiguous genitalia
- hypospadias
- labial adhesions (acquired)
- undescended testes
- Glomerulonephritis
- Haemolytic uraemic syndrome
- Hypertension
- Urinary tract infection
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
- Bartter and Gitelman syndromes
- Chronic kidney disease (CKD)
- Diabetes insipidus, nephrogenic
- Henoch–Schönlein purpura
- Inherited renal disease:
- Alport syndrome
- polycystic kidney disease
- Interstitial nephritis
- Neuropathic bladder
- Renal calculi
- Renal tubular disorders, such as renal tubular acidosis
- Vasculitis and kidney disease
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
- Embryology, anatomy, and physiology of the renal and genitourinary systems, particularly renal physiology pertaining to water and salt balance, acid–base, and regulation of potassium, calcium, phosphorus, urea and creatinine, vitamin D, and erythropoietin
- Fluid and electrolyte status regulation
- Hormonal regulation, including parathyroid hormone (PTH), antidiuretic hormone (ADH), renin–angiotensin system, and its link to the endocrine system
- Natural history of progressive kidney disease
- Nephron anatomy and physiology, including transport mechanisms and electrolyte homeostasis
- Normal urine and electrolyte composition
- Pharmacology of antihypertensive drugs
- Principles of renal replacement therapy, such as transplant and dialysis
- Scrotal pathology
- Structure and function of the renal tract and male and female genital tract
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
- Glomerular filtration rate (GFR):
- GFR estimations (calculate using formulae such as Schwartz formula)
- nuclear medicine GFR
- Paired plasma and urine electrolyte measurements
- Urinalysis (dipstick) testing
- Urinary tract structural and functional imaging:
- micturating cysto-urethrogram (MCU)
- nuclear medicine imaging, such as dimercaptosuccinic acid (DMSA) and mercaptoacetyltriglycine (MAG3)
- ultrasound (recognise gross abnormalities in images and interpret report)
- Urine microscopy and culture
Procedures
- Cannulation
Clinical assessment tools
- Blood pressure measurement
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- Dialysis access options
- Impact of chronic kidney disease on growth and development
- Ongoing management of renal transplant recipients, including immunosuppression
- Role of and indications for radioisotope renography (MAG3 and DTPA):
- in assessing renal outflow tract obstruction
- in the transplant kidney
- Role of nuclear medicine in renal cortical imaging techniques (DMSA) to assess renal scarring and function
- References to patients in the remainder of this document may include their families or carers.