Nephrology and Hypertension Fellowship Program

UofL Health - Jewish Hospital - Organ Transplant Rotation

The transplant program has a robust program for both living and deceased donor kidney, heart, liver, and lung transplantation. Our Transplant Nephrologists work closely with a multidisciplinary team that includes surgeons, transplant infectious disease specialists, transplant coordinators, pharmacists, and other ancillary staff to ensure high quality care. The transplant service cares for all renal transplants (new transplants and post-transplant complications) as well as renal disease in other solid organ transplant patients. There is opportunity to attend committee meetings and learn about patient selection for kidney transplant and donor selection. Fellows learn about immunosuppression management, complications of transplant including infections and cancers. 

UofL Health - Jewish Hospital - General Consult Rotation

This consult rotation provides exposure to common inpatient nephrology conditions, including acute kidney injury, electrolyte imbalances, end stage kidney disease and dialytic therapies. Fellows rotate through the general wards and the ICU's. Focus is on management of chronic dialysis in hospitalized patients, CRRT therapies on the new PrisMax machines, cardiogenic shock, liver failure, hepatorenal syndrome. Advanced heart failure therapies including LVAD, ECMO, Impella and IABP placements are a particular focus on this rotation. 

UofL Health - University Hospital – General consults, Trauma Center and Brown Cancer Center

This consult rotation provides exposure to common inpatient nephrology conditions, including acute kidney injury, electrolyte imbalances, end stage kidney disease and extracorporeal treatment modalities.  Fellows rotate through the general wards and the ICU's.

In addition, due to its affiliation with the Brown Cancer Center, fellows are exposed to unique pathologies including but not limited to onconephrological conditions, chemotherapy-induced nephrotoxicity,and bone marrow transplant associated nephropathies. Fellows also develop proficiency in prescribing and managing therapeutic apheresis procedures, including plasma exchange and red blood cell exchange, for conditions such as sickle cell disease and hematologic malignancies.  As a tertiary level 1 trauma center, the University Hospital also provides additional exposure to high-acuity cases, including, poly trauma, toxic ingestions and overdoses, severe burn injury and volume resuscitation strategies. In collaboration with a robust obstetrics service, fellows also gain experience managing pregnancy-related renal complications, including hypertensive disorders of pregnancy, acute kidney injury in pregnancy. 

VAMC - General Consult service

This consult rotation provides exposure to common inpatient nephrology conditions, including acute kidney injury, electrolyte imbalances, hypertension, end stage kidney disease and dialytic therapies. Fellows rotate through the general wards and the ICU's.

Outpatient Ambulatory Clinics

Core training in ambulatory outpatient clinic continues longitudinally through both years. Fellows will do a ½ day continuity general nephrology clinic through 24 months. Fellows are exposed to a wide variety of patients with chronic kidney diseases, including acute and chronic renal failure, complication of CKD, AKI, hypertension, kidney stones, and cystic disease.

In addition, fellows with also do another ½ day clinic in 5 specialized areas for 2-3 months each year - these include Transplant, Glomerulonephritis, Hypertension, OncoNephrology and Home Dialysis clinic (2^nd year fellows only)

• General Nephrology Clinic 

The General Nephrology Continuity Clinic provides fellows with longitudinal, outpatient care experience, allowing them to follow a panel of patients over time. The focus is on comprehensive management of chronic kidney disease (CKD), electrolyte and acid-base disorders, hypertension, proteinuria, stone disease, and early dialysis/transplant referral. Fellows develop skills in longitudinal care, multi-disciplinary care coordination, and patient education.

• Transplant Clinic 

Advanced outpatient training in kidney transplant evaluation and long-term graft management, with emphasis on immunosuppressive management, acute and chronic rejection recognition, infection surveillance (e.g., BK virus, CMV, opportunistic pathogens), monitoring for metabolic and cardiovascular complications post-transplant and chronic allograft care in a multidisciplinary setting including coordination with surgery, infectious disease, and pharmacy teams. Trainees will also have the opportunity to assess pre-transplant individuals and participate in multi-disciplinary discussions regarding candidacy.

• Glomerulonephritis Clinic

A subspecialty clinic dedicated to immune-mediated and complex glomerular diseases, emphasizing clinicopathologic correlation and evidence-based immunomodulatory therapy. Fellows synthesize kidney biopsy findings, serologic markers, evolving therapeutic approaches including biologic agents, complement inhibitors, and steroid-sparing regimens. Fellows gain longitudinal experience managing IgA nephropathy, lupus nephritis, ANCA-associated vasculitis, membranous nephropathy, FSGS, C3 glomerulopathy, and monoclonal gammopathy–associated renal disease, while monitoring treatment response, relapse risk, and immunosuppression-related complications.

• Hypertension Clinic

A specialized clinic dedicated to the evaluation and management of complex and resistant hypertension. Fellows gain expertise in identifying secondary causes—including primary aldosteronism, renovascular disease, endocrine disorders, and CKD-related hypertension—while integrating ambulatory blood pressure monitoring and advanced pharmacologic strategies. Emphasis is placed on individualized multi-drug regimens, cardiovascular risk reduction, and evidence-based blood pressure targets in high-risk populations.

• OncoNephrology Clinic

A specialized clinic focusing on kidney disease in patients with cancer and those undergoing cancer therapies. Fellows manage acute kidney injury, chemotherapy- and immunotherapy-induced nephrotoxicity, tumor lysis syndrome, renal toxicities of novel biologic agents, bone marrow transplant–associated kidney complications and electrolyte disorders. The rotation emphasizes longitudinal care, coordination with oncology teams at the Brown Cancer Center, and integration of laboratory, imaging, and biopsy data to guide management and preserve kidney function. 

• Home Dialysis

A specialized outpatient clinic for 2^nd year fellows  providing advanced longitudinal training in home dialysis modalities, including peritoneal dialysis (CAPD and automated PD) and home hemodialysis (HHD). Fellows gain experience in patient selection, individualized prescription design, and complication management.

Peritoneal Dialysis (PD): Fellows manage patients on CAPD and automated PD, including prescription adjustment, ultrafiltration optimization, and troubleshooting. Training emphasizes observing patients on training, the prevention, early recognition, and management of peritonitis, exit-site infections, and mechanical complications of PD catheters, as well as adequacy assessment.

Home Hemodialysis (HHD): Fellows evaluate and manage HHD patients, including prescription customization, vascular access assessment, and management of intradialytic complications. Emphasis is placed on observing and participating in patient training, adherence monitoring, and troubleshooting alarms or technical issues.

Outpatient Dialysis Clinics

This elective provides comprehensive exposure to the longitudinal management of patients receiving maintenance in-center hemodialysis. Fellows assume care of assigned 10-12 patients for the duration of their training. This mimics real world experience. Fellows learn to incorporate dialysis rounds in their daily schedule. The fellow rounds 2-3 times/ month on a weekly basis on the patients with at least one of those rounds with the attending faculty. Fellows develop expertise in dialysis prescription, adequacy assessment, vascular access management, anemia and CKD-mineral and bone disorder (CKD-MBD) management along with protocols, interdisciplinary care coordination, and regulatory aspects of outpatient dialysis practice. Social workers, dieticians, nurses, and dialysis technicians provide a strong interdisciplinary team to serve patients’ needs and help nephrology fellow trainees develop the essential skills of caring for dialysis patients. There will be opportunities to participate in monthly quality assurance and performance improvement (QAPI) meetings.

Interventional Nephrology 

This elective is available to both 1^st and 2^nd year fellows. This elective provides hands-on training in interventional nephrology, including renal ultrasonography, fistulograms, graftograms, angioplasty, tunneled dialysis catheter procedures, and ultrasound-guided native and transplant kidney biopsies. Fellows develop procedural proficiency while integrating imaging findings into clinical management.

Vascular Surgery

Trainees will have an opportunity during their second year of training to round with our vascular surgeon in the inpatient and outpatient setting. This elective provides hands-on exposure to dialysis access planning and surgical management, including AV fistula and graft creation, complication management, and vascular preservation strategies. Fellows gain multidisciplinary experience in optimizing vascular access outcomes in CKD and ESRD patients.

Pediatric Nephrology

This 2^nd year elective provides adult nephrology fellows with focused exposure to congenital, hereditary, and developmental kidney disorders encountered in pediatric populations both in an inpatient and outpatient setting. The rotation emphasizes differences in physiology, disease presentation, pediatric dialysis modalities, and transition-of-care principles as well as management strategies between children and adults, while fostering cross-disciplinary collaboration and management of lifelong kidney disease management

Research Elective

This elective provides fellows with hands-on experience in clinical and translational nephrology research, integrating molecular, procedural, and patient-centered approaches. Fellows engage in projects spanning proteomic biomarker discovery, dialysis unit clinical research evaluating anemia management, iron therapy, and mineral and bone metabolism, and industry-sponsored studies assessing novel technologies and interventions in arteriovenous fistula and graft management. In addition, fellows can participate in glomerular disease research, including both laboratory-based mechanistic studies and clinical investigations of biomarkers, disease activity, and treatment response, providing exposure to the full spectrum of translational research in immune-mediated kidney disease. Under faculty mentorship, fellows gain skills in study design, data analysis, and scientific​​ dissemination, presenting findings through manuscripts, abstracts, and conferences. This elective equips trainees with the tools to conduct bench-to-bedside research, contribute to high-impact studies, and prepare for academic and investigative careers in nephrology