Fellows receive their clinical training at Ochsner Medical Center in New Orleans, a state-of-the art multi-specialty facility and referral hospital with over 500 beds that is currently expanding. All clinical rotations are at the Ochsner Main Campus location (OMC). OMC is the centerpiece and referral center of the Ochsner Healthcare System, which includes numerous hospitals and clinics in New Orleans and surrounding cities. It is for that reason that the patients being cared for at OMC have a high degree of acuity and complexity of clinical problems and provide an exceptional opportunity for the fellow to experience all aspects of clinical nephrology.
Clinical training provides a complete range of consultative, diagnostic and treatment services for patients with kidney diseases. The scope of care encompasses all stages of kidney disease, from earliest detectable changes in kidney function through end-stage kidney disease, as well as people with high blood pressure, kidney stones, and other kidney-related problems. The clinical education of the fellow includes training in performing kidney biopsies (transplant and native kidneys) and hands on training in renal ultrasonography. In addition, fellows participate in rotations with the transplant service and interventional nephrology, as well as outpatient chronic dialysis.
There are three consult teams staffed by different faculty. Two teams with house staff support (residents, interns and students) for patients with acute renal problems covering the entire field of nephrology (mainly all forms of AKI, electrolyte imbalances, critical care nephrology) and one team for patients with ESRD who need dialysis support in the hospital while being inpatient.
The fellows training will include the management of various in- and out-patient renal replacement therapies, such as Chronic Renal Replacement Therapy (CRRT), Apheresis, Peritoneal Dialysis, and Home Hemodialysis.
Fellows participate in one weekly outpatient clinic (half day) and follow individual patients longitudinally throughout the fellowship. Patients have a high degree of complexity (including the entire spectrum of glomerular pathology). Each patient is discussed with a faculty member staffing the clinic.
Urine Microscopy Laboratory
Our Department is equipped with a state-of-the-art clinical laboratory for the performance of microscopic examination of the urinary sediment. Fellows perform bright field, dark field, phase contrast and polarized light microscopy under direct supervision and guidance from our faculty. Specimens are inspected with and without Sternheimer-Malbin stain for cell and cast matrix enhancement. Our microscope is attached to a digital camera for teaching purposes as well as allowing fellows to capture images for clinical care and/or oral presentations.
The Nephrology Department was created in 1967 by Dr Julio Figueroa and the chronic dialysis program was initiated in 1972. It has expanded through the years and now includes eight hemodialysis units, peritoneal dialysis, and home hemodialysis.
The main unit in New Orleans, only a couple of blocks from OMC, which opened in 1985, contains a 30 station hemodialysis unit with approximately 120 patients, running six days per week. State-of-the art facilities include centralized water, bicarbonate and acid delivery to the stations, single use dialyzers, noninvasive access monitoring, and paperless computerized medical record. This site also houses the Home Dialysis program (peritoneal dialysis and home hemodialysis), which cares for approximately 20 patients.
The fellows only see patients in the main unit. Each fellow follows 8-10 chronic dialysis patients on a biweekly basis.
Renal Transplant Program
The Ochsner Abdominal Transplant Institute performs approximately 150 kidney transplants a year and the largest number of yearly liver transplants in the United States. Our faculty is comprised of 4 transplant nephrologists and 6 transplant surgeons. In addition, 10 transplant coordinators, 4 transplant social workers, 6 nurse practitioners, and 4 Pharm D complete a team of excellence.
The transplant nephrology faculty is the core faculty for the consultative transplant nephrology service. This service provides acute care, dialytic support, and kidney and transplant expertise for all renal and non-renal solid organ transplant recipients. This service also helps to manage the chronic kidney disease that affects this population.
Outpatient kidney transplant biopsies are performed in our program to better aid in the diagnosis of kidney conditions and a number of different services are provided through the clinic, including focused transplant care, attention to blood pressure, cardiac, bone and metabolic aspects that are unique to transplantation.
Fellows have yearly month long rotation with the transplant team.
Interventional Nephrologists have expertise in vascular access for hemodialysis. There are 2 full time interventional nephrologists at OMC. In addition, we have 2 staff members proficient in renal ultrasonography and kidney biopsy performance. Our kidney biopsy program is run independently, without participation of radiologists and offers unique exposure and training of this procedure for our fellows.
The scope of the interventional nephrology training at OMC includes:
- Ultrasound-guided percutaneous kidney biopsies
- Insertion and removal of tunneled hemodialysis catheters
- Fibrin sheath removal from chronically indwelling central catheters
- Mechanical thrombectomies of clotted hemodialysis catheters
- Mechanical thrombectomies of clotted AVFs and AVGs
- Diagnostic sonography
- Accessory vein ligation
The fellows have a unique opportunity to master the procedure skills guided by fully trained interventional nephrologists, which reduces procedural morbidity for patients and those in need of invasive procedures.
Additional Career Tracks
- Transplant Nephrology
- Nephrology & Critical Care Medicine
Ochsner Medical Center offers an additional 1-year fellowship in either Critical Care Medicine (ACGME accredited, combined LSU/Ochsner Clinic Foundation training program) or Transplant Nephrology. These career tracks will be available as PGY6 for Ochsner Nephrology fellows completing a 2-year clinical fellowship training and graduating in excellent standing.