The dialysis rotation is designed to give the Nephrology fellow experience in the day-to-day management of patients with chronic renal failure dialyzed either at home (hemo- and peritoneal dialysis) or as outpatients in a hemodialysis unit. The fellow takes an active role in teaching the students and housestaff the theory and practice of dialysis management.
Activities include daily rounds on all outpatients dialyzed in-center and discussion of these patients with the dialysis staff. The fellow is expected to attend the weekly center patient review conference and the home dialysis patient review conference. These conferences are designed to enable all members of the dialysis team to discuss each patient in depth. All facets of patient care will be covered including social problems, dietary recommendations and alterations in the daily dialysis prescription according to the metabolic status of the patient. The fellow will also participate in other dialysis modalities such as hemofiltration, hemodiafiltration, and pediatric dialysis, as they occur.
The fellow will also round daily on patients undergoing home dialysis training and will participate directly in the patient training program. In addition, the dialysis fellow will attend the weekly home dialysis clinic (hemo- and peritoneal) and will function as a direct link between these patients and the dialysis team when patients call regarding dialysis problems at home.; Ongoing aspects of the home program will be discussed with dialysis attending staff daily.
These activities are intended to give fellows an in-depth exposure to all modes of dialysis and enables them to formulate realistic strategies regarding patients with end-stage renal failure.