Aubrey Morrison, MBBS, professor of medicine and pharmacology, Renal Fellowship Director Steven Cheng, MD, assistant professor of medicine, Renal Fellowship co-director   Second Edition, Washington Manual Nephrology Subspecialty Consult. Editor, David Windus MD. Chapters written by Washington University Renal Fellows (bold font - see below ) & Faculty   Anne Beck, MD, instructor in pediatrics   Paul Hmiel, MD,PhD, instructor in pediatrics   Marcos Rothstein, MD, professor of medicine and medical director of BJC/WU dialysis services   Drew Heiple MD, postdoctoral fellow   Masanori Tokomoto MD, PhD, postdoctoral fellow   Song-Zhi Li PhD, postdoctoral fellow.   Ethan Hoerschgen, MD, postdoctoral fellow   M. Vittoria Arcidiacono PhD, postdoctoral fellow   Barnes-Jewish Hospital and Nephrology at Barnes-Jewish Hospital is each 'one of the best' in 2008 Qunshan Jia PhD, postdoctoral fellow.

Applying for Fellowships Aubrey Morrison is the Washington University Renal Fellowship Director. Steven Cheng is the co-director. Washington University has openings for Renal Fellows (MD or PhD) who wish to begin training in the academic year 2010-2011 and thereafter. We will accept paper applications at any time (that can be downloaded - see above) for Research and/or Clinical Fellowships from individuals: 1) who wish to train in a specific laboratory at Washington University as part of their fellowship; or 2) who for personal reasons wish to train only in St. Louis and need an early decision. Paper applications can also be obtained from Ms. Lynn Wesselmann (lwesselm@wustl.edu) Other individuals who wish to apply for Renal Fellowships at Washington University and at other institutions should apply through the Electronic Residency Application Service (ERAS) and participate in the Renal Fellowship match. The Division has maintained an active and formally organized postdoctoral fellowship program for more than 50 years. This training prepares selected candidates holding MD or PhD degrees for full-time careers in science and academic medicine. The goals of the training program are: to provide training and direction in the philosophy, methodology, and details of execution of controlled investigations in areas broadly related to renal function in health and disease; to provide training and experience in the interpretation of clinical disorders of the kidney and body fluids and in the use of the necessary diagnostic and therapeutic tools, and to provide the opportunity for the development of teaching skills by trainees through their participation in a teaching program aimed at graduate students, medical students, house officers and fellow trainees. The Division offers a three-year postgraduate fellowship program that provides training in both clinical nephrology and renal science. Designed to meet individual needs, the program is flexible and offers training for predominantly clinically-oriented and exclusively research-oriented fellows. Fourth and fifth years of training, devoted almost exclusively to research, can be provided by mutual agreement between the trainee and the faculty of the Division. Clinical Activities Clinical activities focus on the care and management of patients with diseases of the kidneys and disorders of body fluids. Training experience is broad and equips trainees to approach any nephrologic problem with confidence. Large outpatient practices and clinic facilities, including those directed specifically toward renal transplantation and stone disease, allow the long-term follow-up and management of patients with renal disease and renal transplants. In addition, clinical activities are divided among two chronic dialysis services, two inpatient consultation services and the renal transplantation service, each of which has a full-time faculty physician and postdoctoral fellow in attendance at all times. Chronic Dialysis- Dialysis Network The Renal Division owns and operates four large dialysis units on the Barnes-Jewish campus, and other units off-site in partnership with the BJC Health System and Davita Dialysis Corp. One of the on-campus units, the Chromalloy American Kidney Center, is the oldest dialysis unit in operation in the St. Louis area. Many of the original investigations that determined the way dialysis is performed in the United States today were carried out in the Chromalloy American Kidney Center. The unit participates in the current NIH-sponsored dialysis study. Currently, there are more than 500 outpatients who receive hemodialysis and some 50 patients receiving peritoneal dialysis. Time spent in the outpatient dialysis units allows the acquisition of experience in various dialytic procedures. Postdoctoral Fellows learn a multidisciplinary approach to the medical, social and economic problems facing patients with end-stage renal disease. Inpatient Consultation Service Some 25-50 hospitalized patients are followed by the Renal Consultation Service at any given time. Fellows, who manage these patients, are exposed to a broad spectrum of clinical problems such as acute renal failure, glomerulonephritis, hypercalcemia and complex acid-base disorders. Patients who have unusual diagnostic and therapeutic problems are reported in clinical publications. The fellow gains in-depth experience with acute dialysis, continuous hemofiltration (CVVHD) and in renal biopsy. Clinical rounds are conducted daily. Clinical rotations are supplemented with a series of dialysis seminars and weekly clinical conferences. Renal Transplantation Service The first kidney transplant was performed at Barnes Hospital in 1963. Since that time, the Departments of Internal Medicine and Surgery have participated jointly in an active renal transplantation program. Dr. Daniel Brennan is the medical director of the Renal Transplantation Service. Dr. Bennan is assisted by two other transplant nephrologists, Drs. Matthew Koch and Brent Miller who work in partnership with the Department of Surgery to manage renal transplant patients. Renal fellows help manage each transplant patient while they are in the hospital and are responsible for the outpatient management of an assigned group of transplant patients. In-depth training in renal transplantation is provided to every fellow. Specialized transplantation/fellowship training may be arranged. Approximately 125 renal transplants take place each year with excellent patient and graft survival. Scientific Program The scientific program is carried out at several levels: Clinical studies are helping to define new biomarkers for acute kidney injury for purposes of early diagnosis and for tracking regeneration; Novel protocols for induction-therapy post renal transplantation, are being used to reduce rates of graft rejection; Studies are being carried out to define the process of kidney development using organ culture of isolated embryonic kidneys from embryonic pigs, mice and rats; Efforts continue to clarify the functional properties of the chronically diseased kidney and, in particular, to define the mechanisms which underlie the progression of renal disease; Clinical research continues on uremic patients relating to calcium and phosphate homeostasis, bone disease, vitamin D and parathyroid hormone interrelationships; Investigations are being carried out to characterize patrients' response to frequent (nocturnal) dialysis; Studies are being done to define the molecular basis for differentiation of osteoclasts and macrophages; Studies are being carried out in rats and non-human primates to develop a new therapy for types 1 or 2 diabetes mellitus - growing a new endocrine pancreas from transplanted pig primordia (organogenesis of the endocrine pancreas); Molecular biological and developmental techniques are being used to delineate mechanisms by which the kidney is vascularized during embryonic development; Studies are underway to define molecular defects in the glomerular filtration barrier and in Alport's syndrome using transgenic models; Studies are in progress to define the role of 'Notch' expression during kidney development; An accessible database in being constructed that will contain tissue, plasma and DNA from patients with defined renal disease; An accessible database in being constructed that will contain tissue, plasma and DNA from transgenic mice with defined renal disease; Research is ongoing relating to the molecular and cellular regulation of inwardly recifying K+ channels; Regulation of renal cyclooxygenase expression is being defined using renal cell lines; The role that polymorphisms in the human CD2 AP gene play in susceptibility to focal glomerular sclerosis is being defined; Investigations are being carried out that will define strategies to improve graft function and survival in dialysis patients; Studies are in progress to define the role of RET expression during kidney development; Studies are ongoing that explore the potential use of developing kidneys (metanephroi) for xenotransplantation; Transgenic models are being studied to delineate the molecular etiology of congenital kidney obstruction; Protocols are being developed to facilitate the diagnosis and treatment, and thereby reduce the morbidity of CMV and other viral infections post-renal transplantation. The philosophy of the Division is that renal science transcends the traditional boundaries of nephrology. Therefore, there is extensive collaboration with other medical subspecialty divisions as well as other clinical and basic science departments within the Medical Center through the Division of Biology and Biomedical Sciences (see below). In addition, there is extensive use of a large number of core scientific and clinical facilities within the Medical Center. Conferences The Division and Department of Medicine maintain a full conference schedule. Conferences are attended by faculty, fellows and house staff based at Barnes-Jewish and St. Louis Children's hospitals. Fellows are expected to attend and participate in the Division conferences throughout the year. All staff and trainees attend weekly research conferences, and preference is given to presentations by trainees. A number of endowed visiting professorships and distinguished visiting professors enrich the conference program.

Transplantation Care Conference	Mondays 7:45-8:45 AM
Renal Physiology Core Lecture	Tuesdays 12:00-1:00 PM
Renal Biopsy Review	Tuesdays 1:00-2:00 PM Fridays 1:15-2:00 PM
Renal Research-In-Progress Conference	Wednesdays 2:00-3:00 PM
Renal Transplant Journal Club	Thurdays 7:00-8:00 AM
Renal Clinicopathologic Conferences	Thursdays 12:00-1:00 PM
General Renal Journal Club	Fridays 8:00-9:00 AM
Renal Grand Rounds	Fridays 11:00-12:00 AM
Clinical Teaching Rounds (dialysis, consultation and transplantation)	Daily
Dialysis Lecture Series
Medical Grand Rounds	Thursdays 9:30-10:30 AM
Medical Clinicopathologic Conferences	Fridays Noon-1:00 PM

Former WU Trainees who subsequently have directed or are directing
Renal Divisions in the USA or elsewhere

Trainee - Renal Division
Jacques Bourgoigne, trainee 1963-65 - Albert Einstein College of Medicine & University of Miami
John E. Buerkert, trainee 1974-76 - University of Arkansas
Jacques Chanard, trainee 1974-75 - University of Reims, France
E.J. Dorhout-Mees, trainee 1962-63- University of Utrecht, Netherlands
Robert Dunlay, trainee 1989-91 - Creighton University
Kevin Finkel, trainee 1991-94 - University of Texas Houston
Michael Goligorsky, trainee 1984-86 - New York Medical College
Kevin Harris, trainee 1986-89 - University of Leicester UK
Keith Hruska, trainee 1972-74 - Jewish Hospital of Saint Louis & Saint Louis Childrens' Hospital
Saulo Klahr trainee, 1961-63 - Washington University
Donald Kohan, trainee 1985-87 - University of Utah
Kevin Martin, trainee 1974-77 - Saint Louis University
Peter Morrin, trainee 1958-59 - Queen's College Kingston Ontario Canada
Robert Narins, trainee 1976 -Henry Ford Hospital & Temple University
Tadeusz Orlowski, trainee 1959-1960 - University of Warsaw Poland
Richard Reiselbach, trainee 1962-64 - University of Wisconsin
Alan Robson, trainee 1965-66 - Saint Louis Childrens' Hospital
Bradley Rovin, Trainee 1986-89 - Ohio State University
Anton Schoolwerth, trainee 1970-72 - Pennsylvania State University & Medical College of Virginia
Raymond Schultze, trainee 1961-63 - University of California, Los Angeles
Steve Schwab, trainee 1982-84 - Duke University
Stewart Shankel, trainee 1962-64 - University of California Riverside
V. Matti Vehaskari, trainee 1987-89 - Louisiana State University Pediatric Nephrology
John Walls, trainee 1971-72 - University of Leicester UK

Former WU Faculty who subsequently have directed or are directing
Renal Divisions in the USA or elsewhere

Faculty - Renal Division
Peter C Brazy - University of Wisconsin
Eileen D Brewer - Pediatric Nephrology Baylor College of Medicine
Steven L Gluck - University of Florida & UCSF
L Lee Hamm - Tulane
Marc R Hammerman - Washington University
John Stokes III - University of Iowa

The Washington Manual® Nephrology Subspecialty Consult, 2nd Edition 2008: Table Of Contents
WU Renal Fellow Authors are in bold font

PART I. GENERAL APPROACH TO KIDNEY DISEASE
1. Art and Science of Urinalysis - Anton Cabellon
2. Assessment of Kidney Function - Sijie Zheng
3. Renal Biopsy - Imran A. Memon
4. Approach to Proteinuria - Kabeya Mwintshi
5. Approach To Hematuria - Rouba Ghoussoub
PART II. ELECTROLYTES AND ACID-BASE DISORDERS
6. Disorders of Water Balance: Hyponatremia and Hypernatremia - Andrew Siedlecki and Matthew J. Koch
7. Disorders of Potassium Balance - Matthew J. Koch
8. Disorders of Calcium Metabolism - Jawad Munir
9. Disorders of Phosphorus Metabolism - Jawad Munir
10. Acid-Base Disorders - Bala P. Sankar
PART III. ACUTE KIDNEY INJURY AND CONTINUOUS RENAL REPLACEMENT
11. Overview and Management of Acute Kidney Injury and Acute Tubular Necrosis - Anitha Vijayan
12. Prerenal and Postrenal Acute Kidney Injury - Alexis Argoudelis and Anitha Vijayan
13. Intrinsic Causes of Acute Kidney Injury - Kamal Sambandam
14. Contrast Induced Nephropathy - Ethan Hoerschgen and Anitha Vijayan
15. Renal Replacement Therapy in Acute Kidney Injury - Anitha Vijayan
PART IV CAUSES OF KIDNEY DISEASE
16. Overview and Approach to the Patient with Glomerular Disease - Rasa Kedainis
17. Primary Glomerulopathies - David Windus
18. Glomerulonephritis in Multisystem Disorders -Nadine Tanenbaum
19. Diabetic Nephropathy - Steven Cheng
20. Renal Artery Stenosis and Renovascular Hypertension - Matthew C. Lambert
21. Cystic Diseases of the Kidney - Michele Cabellon
PART V. PREGNANCY AND NEPHROLITHIASIS
22. Renal Diseases in Pregnancy - Drew C Heiple
23. Nephrolithiasis: Physicochemical Principles and General Management - Sreedhara B Alla
PART VI CHRONIC KIDNEY DISEASE
24. Management of Chronic Kidney Disease - Daniel O. Young
25. Hemodialysis - Steven Cheng
26. Peritoneal Dialysis - Seth Goldberg
27. Principles of Drug Dosing in Renal Impairment - Christine Spaeth-Kelso
28. Care of the Renal Transplant Patient - Andrew Siedlecki and Matthew J. Koch

Renal Division Department of Internal Medicine Washington University School of Medicine