Level 1: Foundation course in Intensive Care Nephrology

Pathway directors

• Bairbre MCNICHOLAS MD PhD Consultant Intensivist and Nephrologist at Galway University Hospitals; Senior lecturer, University of Galway, Galway, Ireland
• John PROWLE MD, FRCP, FFICM Senior Clinical Lecturer in ICM, Queen Mary University of London, Consultant in Renal and Intensive Care Medicine, Royal London Hospital, London, United Kingdom

Directors Level 1

• Greet DE VLIEGER MD PhD intensive care physician, Universitair Ziekenhuis Leuven, Leuven, Belgium
• Eric HOSTE MD PhD Intensive Care Department, Ghent University Hospital, Ghent, Belgium
• Marc ROMAIN MD, MBBCh, DCH(SA), FCP(SA) Specialist intensivist and nephrologist, Medical intensive care unit, Hadassah Medical Center; Hebrew University of Jerusalem, Jerusalem, Israel
• Antoine SCHNEIDER MD, PhD Service de Médecine Intensive Adulte (SMIA), Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland; Chair of Acute Kidney Injury (AKI) section, ESICM

Outcome 1: Epidemiology/Risk of AKI
Demonstrate understanding of the epidemiology of acute kidney injury (AKI).
Recognise risk factors for AKI.
Distinguish between modifiable and non-modifiable risk factors of AKI.Perform a focused clinical examination to identify parameters relevant to AKI.

Outcome 2.  Prevention of AKI
Explain and apply risk stratification for AKI based on patient characteristics.
List appropriate tests to diagnose and follow patients at risk for AKI.

Outcome 3: Describe pathophysiology of AKI
Identify common causes and clinical settings associated with AKI.

Outcome 4: Diagnosis of AKI
Describe and apply current staging criteria for diagnosing AKI.
Demonstrate understanding differences in urine and serum creatinine in defining AKI.
Explain the limitations of creatinine for diagnosis of AKI.

Outcome 5: Long-Term Implications of AKI and RRT
Recognise long term effects of AKI including increased risk of death, cardiovascular events and major adverse kidney events (MAKE).

Outcome 6: Pharmacology in AKI and RRT
Define nephrotoxicity and its relevance to acute kidney injury (AKI).
Describe mechanisms of nephrotoxin-induced kidney injury.
Identify high-risk drug classes and patient groups.
Discuss strategies to detect, attribute, and mitigate nephrotoxic injury.
Understand the use of diuretics in the diagnosis and management of critically ill patients with AKI.
Understand the implications of alter volume of distribution and clearance on drug dosing (particularly of anti-microbials) during AKI and RRT.

Outcome 7A: CRRT/RRT- Component and mode
Identify and describe the components of a continuous renal replacement therapy (CRRT) machine.
Describe the key modes of CRRT.
Explain the mechanisms of Solute and Fluid Removal during CRRT.
Define key terms: convection, diffusion, ultrafiltration.

Outcome 7B: Vascular Access for CRRT
Identify common vascular access sites for CRRT.
List equipment needed for central venous catheter (CVC) insertion.
Demonstrate knowledge of the anatomy and physiology of major vascular structures relevant to vascular access for CRRT.
Identify key complications associated with CVCs.
Identify indications and contraindications for CVC placement and apply principles of infection prevention during placement and maintenance.

Outcome 7C: Prolonged intermittent RRT (PIRRT) “Sustained Low-Efficiency Dialysis (SLED)”
Nil

Outcome 7D: Renal Replacement Therapy (RRT)
Explain the clinical indications for initiating RRT and recognise potential complications.
Identify absolute indications to start RRT.
Identify potential indications to start RRT.
Identify potential complications of RRT.

Outcome 8: Role of the Kidney in Homeostasis During Critical Illness
Explain the mechanisms by which the kidneys regulate acid base status.
Interpret arterial blood gases to evaluate renal contribution to acid base abnormalities.
Manage metabolic complications of renal failure and treat of hyperkalaemia/hypokalaemia.

• Definition(s) and staging
• Epidemiology
• Nephrotoxicity
• Prevention / Management
• AKI Pathophysiology
• AKI related metabolic abnormalities
• Pharmacology in AKI and RRT
• Indication and Timing for RRT initiation
• Vascular access
• Circuit Setup Filter and haemodynamics
• CRRT: Dose, Modality and Fluid Composition
• RRT modality
• Anticoagulation for CRRT, citrate basics
• RRT discontinuation / transition to IHD / Outcomes
• CRRT Alarms and troubleshooting
• Extracorporeal organ support (ECOS)

Junior intensivists seeking a thorough approach to Intensive Care Nephrology
Any practitioner who wishes to review the fundamentals of this topic

Support Emerging Nations and Eastern Europe

ESICM members from the Emerging Nations and Eastern Europe (see list of countries here) are entitled to an discount on registration fees. To qualify, participants must be active ESICM members for the current year. To become a member, please see more information here.

ESICM members from the Emerging Nations and Eastern Europe (see list of countries here) are entitled to an discount on registration fees. To qualify, participants must be active ESICM members for the current year. To become a member, please see more information here.

An application will be made to the UEMS EACCME® for CME accreditation of each live event.