Acute renal replacement therapy during hospitalization: Is training adequate?

Abstract

Acute renal replacement therapy is one of the most common interventions provided by nephrologists, however, data on the quality of training provided to nephrology fellows is limited. Extensive curricula for acute renal replacement therapy and the management of poisonings and intoxications have been published, but personal experience suggests that there are significant opportunities to improve training. Particular areas to be considered include the use of novel technologies for assessment of volume status, greater emphasis on the dosing of medications during acute renal replacement therapy, greater training in assessing and tailoring treatment to the goals of care of the individual patient, incorporation of continuous quality improvement tools into the management of acute renal replacement therapy programs and development of robust simulation training to augment training.

An Introduction to dialysis education: Issues, innovations and impact

“…Palevsky comprehensively reviews the currently published core curricula and assessment of the quality of training provided in this area and addresses in detail specific issues related to acute renal replacement therapy training. For example, Palevsky's manuscript addresses issues with initiation and discontinuation of acute dialysis, troubleshooting of the extracorporeal circuit, volume management, and shared decision‐making in the setting of acute kidney injury among others. As a complementary manuscript, Duronville and Diamantidis tackle medical safety issues in the care of patients with ESRD.…”