ACGME Fellowship

Research Training

Subject Matter Expert Tracks

During the second year of training, fellows are enrolled in a Subject Matter Expert Track and focus on the goals outlined in their IDP. The tracks provide close mentorship and training in a focused area in nephrology. Given the rapid pace of expansion of medical evidence and knowledge in the field of Nephrology, we believe that modern training in nephrology requires specialized and focused experience and training to ensure success in both academic and clinical practice. The tracks outlined below assure an integrated experience in both clinical and research training in each track. Fellows engage in clinical and didactic activities and complete a related scholarly project. Current subject matter expert tracks include:

Metabolic Stone and Bone Disease

Directors: Drs. Fred Coe, Megan Prochaska, Elaine Worcester, and Anna Zisman
Kidney stones are common and associated with significant morbidity and mortality. Preventive treatment is effective in preventing recurrent stone disease. Our Kidney Stone Program includes an active research group that focuses on understanding mechanisms for kidney stone formation. Our goal is to apply our research to patient care by developing new prevention strategies.
We have multiple different research projects and active protocols. Many of our studies are patient based physiologic studies. For such studies, research participants come to the University of Chicago Clinical Research Center and we collect urine samples, blood samples, and other tests that help us test mechanisms for stone formation. Our current protocols include studies testing the association between oxalate and citrate, differences in oxalate absorption for different kidney stone patient types, and inflammation and insulin resistance in kidney stone participants. We also collaborate with our endourology faculty on protocols studying the role of intraoperative papillary grading in kidney stone formers to elucidate mechanisms of stone formation, as well as racial differences in mechanisms of stone formation.
In working with our Kidney Stone Program, nephrologists learn the physiology of mineral metabolism in kidney, bone, and the gastrointestinal tract, including the impact of changes in hormonal balance, as well as acid-base and sodium balance. Trainees will not only learn about kidney stone research but also become well-trained in the management of kidney stone patients.

Vascular Access

Directors: Dr. Mary Hammes and Dr. Rita McGill
Vascular access outcomes are a key determinant of morbidity, mortality and cost for patients with ESRD. In the last 10 years, technical advances, understanding of vascular biology, and therapeutic options have exponentially increased. There is growing recognition that dialysis-related expertise regarding vascular access placement and maintenance and management of access complications is necessary to provide appropriate care and optimize outcomes for our patients. Multidisciplinary teams including interventional radiology, vascular surgery and nephrology provide the training necessary to become a subject matter expert with regard to vascular access.

Home Dialysis

Directors: Dr. Samantha Gunning and Dr. Kevin Nash
Lifestyle benefits, efficacy, cost saving, and national directives since the Advancing American Kidney Health initiative in 2019 have made home dialysis modalities – both home hemodialysis and peritoneal dialysis – more popular and frequent. Nephrology fellows at the University of Chicago benefit from training in a home dialysis program to help address the needs of their future home dialysis patients.
The home dialysis curriculum serves fellows over the course of their entire two years of clinical training. This involves a didactic course paired with clinical experiences in the home dialysis unit directly evaluating patients during the course of their home dialysis treatments. The curriculum addresses home hemodialysis and peritoneal dialysis prescription writing, patient selection and training, management of peritoneal dialysis access and complications, and management of home hemodialysis access. During the course of the clinical experience, fellows will also be exposed to the multi-disciplinary care team including home dialysis nurses, nutritionists, surgeons, and social workers.

Critical Care Nephrology

Director: Dr. Jay Koyner
Nephrologists are increasingly consulted to care for patients with acute kidney injury (AKI), electrolyte disorders and other forms of kidney diseases in the highly subspecialized worlds of Critical Care. Management of these patients often requires an understanding of not only the nephrology issues but also the management and treatment options from a critical care perspective. New treatment interventions (devices, immuno-therapeutics, and treatment strategies) continue to evolve and also to adversely impact patients and their kidney function. In this track, the fellow will have exposure and hands-on experience across multiple ICUs and the rapidly changing landscapes of critical care. Over the last 17+ years our nephrologists have collaborated with researchers and clinicians from the Section of Pulmonary Critical Care, as well faculty from the Departments of Anesthesia and Critical Care Medicine, Surgery and Neurology. Dr. Koyner and his team have performed clinical and translational research in patients at high risk for AKI as well as those with established AKI.

Hereditary Kidney Disorders

Directors: Dr. Arlene Chapman and Dr. Bharathi Reddy
In the post-genomic era, practical and translational application of genetics in kidney disease is required in daily clinical practice and is a critical component of the study of all kidney diseases. This track will provide an understanding of Mendelian and complex medical traits and laboratory approaches to evaluation of genetic contributions to disease (direct Sanger sequencing, next generation sequencing, single cell genetic analyses). Fellows will develop a rational approach to diagnostic work ups, risk stratification, and precision management of patients with chronic kidney diseases. Through pharmacogenomics approaches, an understanding of the associations with disease severity, appropriate medication choices and dosing will be achieved. Training will also include experience in gene-based, genome wide association, microRNA, whole exome and whole genome studies. Genetically tailored therapeutic options for kidney diseases and their management will be provided. This track provides fellows with the training necessary to apply genetic concepts in practice as well as participate in basic, translational and clinical research projects.

Hypertension Subspecialization

Director: Dr. Mohammed Rafey
Hypertension occurs in over 90% of our patient population and globally, essential hypertension is one of the most common contributors to patient morbidity and mortality. Key to the management of hypertension is a detailed understanding of its pathogenesis in the setting of chronic kidney disease, cardiovascular disease and endocrine disorders and the consequences of hypertension with regard to patient outcomes. This Fellowship track, offered in conjunction with the AHA Comprehensive Hypertension Center at the University of Chicago, provides specialized training in the clinical management of difficult to treat hypertension, hypertension in chronic kidney disease, heart failure and endocrine disorders, understanding of abnormalities in tubular transporters, systemic and renal hemodynamic contributors to hypertension, and competency in the strategies that delay or prevent the consequences of poorly controlled hypertension in heart and kidney disease. Expertise in evaluation and management of secondary forms of hypertension are offered and inpatient consultative services for consults regarding management of hypertension are a part of this fellowship. Projects are conducted in basic, translational, or clinical research as a part of this fellowship. Fellows are welcome to participate in the annual Hypertension Council AHA meeting.