501869 - NEPHROLOGY

courses

ID:

501869

Duration (hours):

32

CFU:

SSD:

NEFROLOGIA

Year:

2025

Date/time interval

Primo Semestre (01/10/2025 - 16/01/2026)

Course Objectives

At the end of the course, the student, also integrating the knowledge of anatomy, biochemistry, physiology, general pathology already acquired previously, will have to demonstrate knowledge and understanding about:
- the pathophysiological phenomena underlying the clinical aspects of hydrosaline and acid-base imbalances;
- the causes and symptoms of the main clinical syndromes associated with different nephropathies, urinary infections, nephro-urinary stones;
- typical complications of patients with kidney disease;
- the pathophysiological and clinical aspects of acute and chronic renal failure and the replacement therapy of end-stage renal failure (dialysis and renal transplantation)

Course Prerequisites

The student must have passed the Anatomy and Physiology exams

Teaching Methods

frontal lessons with the use of audiovisual supports and classroom discussion with students, seminars, clinical cases, quizzes

Assessment Methods

The verification of the achievement of the objectives set by the course includes an oral exam.
Through questions regarding the contents of the course, it will be ascertained whether the student has achieved the objective of knowledge and understanding of the contents of the course itself. During the course, students will have the opportunity to participate in two ongoing written tests (30 questions with multiple choice answers) each covering 1/3 of the course. Students who pass the two tests will be able to participate in an exam session which will include the topics covered in the third part of the course.

Texts

Primers on Kidney Diseases;
Harrison's Internal Medicine

The Nephrology course is part of the Integrated GI and Urinary Tracts Course. The course provides the student with a) the elements to know and understand the etiology, pathogenesis, symptoms, diagnostics and therapy of the main nephropathies, including the different forms of renal function replacement therapy (hemodialysis, peritoneal dialysis and renal transplantation); b) the knowledge and understanding useful for identifying the problems of patients suffering from kidney disease.
Initial lessons will cover volume, serum electrolytes and acid-base balance disordwers. The second part of the course is aimed at discussing elements of pathogenesis, semiology, diagnosis and principles of therapy of primary and secondary glomerular nephropathies, congenital and acquired tubulointerstitial, and vascular nephropathies and acute kidney injury. The third part of the course is dedicated to chronic kidney disease and the replacement therapy of end-stage renal failure, including dialysis and renal transplantation in their various forms and complications.

Extended program
- General diagnostics of kidney diseases: proteinuria, micro- and macro-hematuria, nephritic syndrome and nephrotic syndrome
- Creatinine, urea nitrogen, clearance concept, glomerular filtration rate calculated, measured and estimated.
- Pathophysiology of salt and water retention and pathogenesis of edema; pathophysiology and clinic of volume depletion states
- Hyponatremia and hypernatremia
- Alterations of the acid-base balance
- Diuretics in edematous states
- General aspects of nephroprotection (ACE inhibitors, angiotensin II receptor inhibitors, other antihypertensives, statins, etc.).
- Nutritional approach to chronic kidney disease
- Glomerular nephropathies:
Clinico-histopathological aspects, course and therapy of:
acute post-streptococcal and post-infectious glomerulonephritis; rapidly progressive glomerulonephritis; membranous glomerulopathy, minimal lesion glomerulopathy, focal and segmental glomerulosclerosis, membranoproliferative glomerulonephritis, mesangioproliferative glomerulonephritis with predominantly IgA deposits, glomerulonephritis
Secondary glomerular nephropathies and main elements of the underlying systemic disease:
general classification. Clinical aspects, anatomo-pathological pictures, course and therapy of:
diabetic nephropathy, lupus nephropathy, deposition nephropathy (amyloidosis, multiple myeloma); nephropathies secondary to vasculitis (Wegener's granulomatosis, micropolyangiitis, Churg Strauss disease, cryoglobulinemic nephropathy, Henoch Schoenlein disease)
- Congenital tubular nephropathies.
- Acute and chronic, non-infectious and infectious tubulointerstitial nephropathies.
- Cystic renal diseases.
- Nephroangiosclerosis; renal artery stenosis
- Acute renal failure: etiopathogenesis, clinic, therapy.
- Chronic kidney disease: a) etiopathogenesis, clinic, therapy; b) complications: calcium-phosphorus, hydro-electrolyte, acid-base imbalances; anemia, cardiovascular disorders.
- Dialysis: hemodialysis and peritoneal dialysis: Physicochemical principles, indications, efficacy and limits, complications. Most frequent clinical problems of dialysis patients.
Notes on the history of renal transplantation
Corpse donor from encephalic lesions and circulatory death
Living donor
Pre-emptive transplant
Approach to incompatible donor-recipient pairs
Rejection classification
Immunological mechanisms of rejection
Anti-rejection therapy
Histological lesions of rejection
Other causes of graft dysfunction
Recurrence of primary renal disease
Nephrotoxicity from immunosuppressive drugs
Surgical complications of renal transplantation
The recipient's medical complications
Infections after transplantation: timeline and type
CMV infections
Neoplasms after transplantation (PTLD, and M.di Kaposi)
Side effects of anti-rejection treatment