Clinical Experience - Nephrology Fellowship Program

At Ochsner Health System, we take pride in providing a healthy learning environment for our fellows. In recent years, we focused on building a team of advanced practice providers to support our fellows and staff in their clinical duties. Because of that, even though our department sees a large number of patients every day with an exceptional clinical diversity, our fellows are responsible for a limited amount of daily progress notes and therefore can focus on excelling in academic nephrology.

Weekday Call

We have six clinical fellows. Each fellow takes overnight home call every 1 in 6 nights; The on-call fellow will only cover patients at the Ochsner main campus (one hospital). Fellows are encouraged to go home early on post-call days

Weekend Call

Every fellow covers 1 in 6 weekends. On weekends there will be APP and resident support.

For our 6 clinical fellows (3 first-year fellows and 3 second-year fellows)

Our fellows will have the opportunity to choose from clinical electives in multiple subspecialties to gain in depth knowledge in certain fields important for the care of patients with kidney failure.

• Interventional (at LSU Baptist hospital in New Orleans and LSU Shreveport campus)
• Cardiorenal elective
• Vascular surgery elective
• Blood bank (Apheresis) elective
• Research elective
• Ultrasound elective
• Other electives possible (off campus)
• Palliative care elective

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 110 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 30 patients. The fellows only see patients in the main unit. Each fellow follows 8-10 chronic dialysis patients on a biweekly basis.

The fellows inpatient training will include the management of various renal replacement therapies, such as Chronic Renal Replacement Therapy (CRRT), Apheresis, Peritoneal Dialysis, and Home Hemodialysis. During the ICU rotations our fellows will be trained in SLED, CVVHD and CVVHDF, including state of the art PrismaFlex and PrisMax systems.

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 rotations with the transplant team.

Interventional Nephrologists have expertise in vascular access for hemodialysis. At this time we partner with the Louisiana State University (LSU) at their Baptist hospital location (New Orleans) as well as LSU Shreveport Academic Medical Center, a well-established interventional nephrology program, to train our fellows in interventional nephrology.

In addition, we have 4 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.

Our program owns a state-of-the-art ultrasound machine and we also purchased 3 ultraportable handheld Vscan GE ultrasound devices, one for each consult team to incorporate POCUS into our clinical decision making.

The scope of the interventional nephrology training includes:

• Ultrasound-guided percutaneous kidney biopsies
• Diagnostic ultrasound
• Insertion and removal of tunneled hemodialysis catheters
• Fibrin sheath removal from chronically indwelling central catheters
• Mechanical thrombectomies of clotted hemodialysis catheters
• Angiograms
• Angioplasties
• 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.

• 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.