The programme therefore provides:

• Clinical exposure and teachings on diagnostic approach and management of complex renal cases both at inpatient and outpatient levels.
• Training where applicable (Paediatric Subspecialty Training) on procedures required of nephrologists like renal biopsy and peritoneal dialysis.
• Guidance in the design and critical analysis of projects and clinical studies on renal diseases.

Inpatient

Renal cases including UTI is one of the leading admissions to the hospital.

Inpatient nephrology services include:

• Renal consultations within the Department of Paediatric Medicine including Intensive Care Unit. Cases include complex renal diseases, fluid / electrolyte problems, glomerulonephritidis, difficult nephrotics, tubulopathies, acute and chronic renal failure.
• Inter-departmental renal referrals:
  • Neonatology (congenital nephropathies)
  • Neonatal ICU (acute renal failure)
  • General Surgery (uropathies, chronic renal failure)
  • Cardiothoracic surgery (Post-operative fluid overload / acute renal failure).

Outpatient Services

There is a large renal outpatient pool with more then 2,500 attendances a year.

• General Nephrology: There are 5 general nephrology clinics a week run by a Senior Consultant and an Associate Consultant. In addition, there are 2 renal clinics run by registrars / medical officers under close supervision. Fellows are expected to run these supervised clinics.
• Voiding Dysfunction Clinic: Weekly clinic with participation of urologists (urodynamic study) and physiotherapists (bladder training / enuresis alarm training).
• Spina Bifida Clinic: Nephrologist input for management of neuropathic bladder.

• Renal biopsy: Ultrasound guided real-time biopsies are done regularly with full histological diagnostic facilities. Nephrology subspecialty trainee will be required to undergo training in this area.
• Training in other procedures include acute peritoneal dialysis procedure and prescription. Continuous veno-venous haemodialysis (CVVH) is part of nephrology subspecialty training. Part of the training may also include an adult renal centre for larger patient pool and exposure.
  

• Clinical bedside teachings during renal ward rounds and outpatient clinics.
• Weekly grand renal round (Thursdays) including discussion of difficult cases and management problems.
• Departmental teachings: Renal cases are discussed on rotation basis with other subspecialties which include case presentation (Thursday), journal presentation (Friday) and morbidity round (Friday).
• Research is mainly clinical-based including clinical trials, demographic studies and outcome analysis. A database for renal diseases is also being set up. Areas of interest include acute pyelonephritis and reflux nephropathy, voiding dysfunction and lupus nephritis.

• Advanced paediatric training: May include nephrology training of up to 6 months, with possibility of leading to subspecialised nephrology training. The scope and depth of training will be limited, excluding training in renal biopsy and dialysis.
• Subspecialised (Nephrology) training: Comprehensive training of up to 1 year is required to include all aspects of paediatric nephrology, including renal biopsy and histological interpretion as well as dialysis methods and prescriptions. Completion of training will lead to certification of training in paediatric nephrology.