Our dialysis program, under the leadership of Dr. Mony Fraer, gives the fellows an in-depth exposure to the two main modes of outpatient dialysis, center and home therapies (hemodialysis and peritoneal dialysis), enabling them to formulate realistic strategies to select the option most suited to their patient with ESRD. Care for the ESRD patient involves a multidisciplinary team approach that includes the fellow, staff nephrologist, social worker, dietician, and nurses.
The fellow will be assigned as the primary fellow, along with one staff, to one hemodialysis shift at UIHC for a year. This continuity of care allows the fellow to experience the day-to-day management of the patient with ESRD on maintenance dialysis. The fellow will round once weekly with the staff on these patients and gradually assume independent responsibility in decision-making for these patients. All facets of patient care will be covered, including monthly lab review, dietary recommendations, adjustments in dialysis prescriptions, evaluation of access problems, and social issues. In the second year of training, the fellow will switch to work with another staff and group of patients on a new hemodialysis shift.
Home Dialysis Program
We currently have about 24 patients on home hemodialysis or peritoneal dialysis in our home dialysis program, one of the longest-running in the country. Each patient is assigned one staff and one fellow, who see the patient monthly in the clinic. For those patients beginning training, the fellow rounds once weekly with the staff and makes any necessary prescription changes.
Continuous Renal Replacement Therapies
The fellow will become familiar with all the modalities of continuous renal replacement therapy (CRRT), the role of hemoperfusion in the management of drug intoxication, and the use of ultrafiltration techniques on inpatients requiring this modality.