Consultation Service UI Hospitals & Clinics

The University of Iowa Hospitals & Clinics Nephrology Consult Services form the core of the fellow's clinical learning experience. Fellows will spend 8-10 months rotating through the 2 consult services in the course of the two-year program.   A couple of years ago our traditional one consult service was split into 2 as the volume of consultations increased.  The goal of creating an Acute service (acute floor or ICU consults) and Chronic service (all ESRD admissions) was to provide quality and safe patient care in a consultative role and to continue to maintain the education value of the renal consult service for our trainees.  The Acute service (Team A) is staffed by 1 renal fellow, 1 nephrology staff and incorporates all resident and student learners.  The Chronic service (Team B) is staffed by 1 renal fellow and 1 staff.

For each of these services, the fellow assumes significant responsibility for running the Nephrology Consult Service. Under the supervision of the attending nephrologist, the fellow will oversee the daily management and diagnostic evaluation of all patients on whom the service consults and learn how to manage acid base and electrolyte disorders, acute and chronic kidney disease, hypertension, intoxications, and other renal-related diseases. The fellow’s responsibilities will include decisions regarding initiation of dialysis, selection of modality and writing and/or supervising dialysis prescription for patients with acute kidney injury. The fellow will become familiar with all the modalities of continuous renal replacement therapy (CRRT), the role of hemoperfusion in the management of drug intoxication and the use of ultrafiltration techniques. In addition, the fellow will also become adept at percutaneous renal biopsies. The fellow will also be intimately involved in teaching medical students and residents on the nephrology consult A team and will function as a liaison between the consultation service at UI Hospitals & Clinics and the referring physicians/teams.

Consultation Service VAMC

The Iowa City Veterans Affairs Medical Center, conveniently situated adjacent to the University of Iowa Hospitals, plays a vital role in our nephrology fellowship program. As part of the program, the nephrology fellow assumes responsibility for overseeing three essential services at the Iowa City VA Health Care System: inpatient consults, outpatients in the renal clinic, and organizing and performing procedures. This collaborative engagement with the VA offers an exceptional opportunity for fellows to gain extensive exposure to the distinctive aspects of nephrologic care specifically tailored to this patient population.

At the VA, fellows participate in a general nephrology clinic that provides valuable insights into the distinctive characteristics of care required by Veterans. The patient population at this clinic predominantly consists of individuals with chronic kidney disease, renovascular hypertension, diabetes, and geriatric renal disease, with a higher representation of male patients. This exposure allows fellows to acquire a comprehensive understanding of managing renal conditions in this specific demographic.

By integrating the Iowa City Veterans Affairs Medical Center into our nephrology fellowship program, we aim to offer fellows an immersive experience that encompasses the intricacies of nephrology care within the context of Veteran healthcare. This exposure not only enhances fellows' clinical competence but also cultivates a deep appreciation for the unique challenges and considerations that arise in the care of Veterans with renal conditions.