Transcript

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Nephrology Fellowship logbook

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CONTENTS ………………… Instruction for the use of the logbook …………………………………………………………………..

Cases & conditions…………………………………………………………………..…………………………………………

Renal replacement competencies………………………………………………………………………...

Procedures……….. …………………………………………………………………..……………………………………

First year logbook …………………………………………………………………..…………………………………………

Clinical nephrology I …………………..………………………………………………..…………………………

Academic activities …………………………………………………………………..…………………………

Procedures log 1……... …………………………………………………………………..……………………………

Dialysis logbook 1…………………………………………………………………..…………………………………………

Transplantation log 1 …………………………………………………………………..……………………………………

Second year logbook…………………………………………………………………..……………………………………

Clinical nephrology 2 …………………..………………………………………………..…………………………

Academic activities 2…………………………………………………………………..…………………………

Renal ICU……………………………………………………………………………………………………………………..

Procedures log 2……... …………………………………………………………………..……………………………

Dialysis logbook 2…………………………………………………………………..…………………………………………

Transplantation log 2 …………………………………………………………………..……………………………………

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69

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83

91

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وب ردتايسلس ب ردس و فشارس و تسيفشتسملا

فشس وب ردا فشس وب ردا

يريتمس فابس وب ردا

(ميفس ل لااس و فشار) يريتمس فابس وب ردا

(ميفس ل لااس و فشار)

ايشس ياشس ايشس ياشس وب ردا وب ردا

فشس وب ردا فشس وب ردا

يريتمس فابس وب ردا

(ميفس ل لااس و فشار) يريتمس فابس وب ردا

(ميفس ل لااس و فشار)

ايشس ياشس ايشس ياشس وب ردا وب ردا

متالايس نعتةسصخس وب فشت

س سفش

سياشالس وبتات

سسس وينر ا

سسشيشسيب تلس د لوةس وبلنة

سشيشس و اتدرا

سشيشس وب برر

سس ووبافس اود بللت

سسس و نعل

سسياشالس وةوررسماود اوةس وبعباة

ةرشخس نعتة

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Instructions for the use of logbook

Aim of the logbook

The purpose of the logbook is to provide one source of evidence for the ne-

phrology scientific council that you attained the desired level of competency

required for licensure. It is the place where you are going to document experi-

ences and skills you attained during your training.

The logbook is divided into several sections. These instructions will help you

completing those sections correctly.

Personnel information

Please fill in all your personnel information required. This will help the Egyp-

tian Fellowship Administrators to process your logbook during scientific coun-

cil evaluation yearly and finally before sitting for the final exam. Your person-

nel photo should be attached to the logbook and you should sign the personnel

information page

Clinical nephrology , dialysis and transplantation case log

1. You will find lists with all required cases in the curriculum. Your level of

participation in each case and expected activities are also determined

2. You need to mention the patient data, management provided and case pro-

visional & final diagnosis

3. For each case write the date of the interview

4. Make a check mark at the appropriate column indicating your level of par-

ticipation in case management (observer, supervised management of the

case or independent management of the case)

5. Each case should be counter signed by your trainer. His signature is the

proof of your actual participation. The trainer signature should be very

clear

Procedures’ log

1. The logbook contains tables for required procedures during different stages

of training and the level of desired performance at each stage.

2. You will also find empty tables to write down the procedures, your level of

participation and the date.

3. Your trainer should countersign each procedure to document the event

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Academic activities

1. Academic activities that must be documented are lectures, journal clubs,

morbidity and mortality meetings and workshops or conferences at-

tended.

2. Any attended activity must be signed by the workshop or conference organ-

izer/coordinator. At least two national conferences in the field of nephrol-

ogy must be attended

Rotation Proof

Your scientific council has determined specific rotations in subspecialties

that you must go through during the training period (see your curriculum for

details). After you finish each rotation sign its block by the Hospital/training

center manager and stamp officially.

Assessment of logbook activities

1. Your trainer will assess your logbook weekly for completion and provide

feedback

2. Your educational supervisor will assess your logbook monthly or every two

months, provide verbal or written feedback and counter sign important ac-

tivities

3. The examination committee of the scientific council will revise your log-

book:

A) Annually before you progress from one year of training to another

B) At the end of training before the final exam

To be noted that unsatisfactory completion of the logbook would lead to delay

of training progression.

Unsatisfactory logbook at the end of training will prevent you from entering the

final exam

Important Notice:

It is your responsibility to maintain accurate and completed logbook and to regu-

larly update your records. Shall you meet any difficulty; you must contact your

trainer or your specialty administrator at the Egyptian Fellowship Board.

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Core Conditions and procedures that must be Managed Competently

by Nephrology Trainees

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Clinical condition Clinical condition

Renovascular diseases Arterial and venous thrombosis

Thrombotic microangiopathies Renal vasculitis

Clinical condition Clinical condition

Gross Hematuria Microscopic hematuria

Asymptomatic proteinuria Nephrotic syndrome

Nephritic Syndrome Rapidly progressive glomeru-

lonephritis

Chronic glomerulonephritis

2. Vascular Disease

1. Glomerular Diseases

Clinical condition Clinical condition

Renal tubular acidosis Renal tubular rickets

Bartter syndrome Nephrogenic diabetes insipidus

Interstitial nephritis Hyperoxaluria

3. Tubulo-interstitial disorders

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Clinical condition Clinical condition

Acute and recurrent urinary tract infections

Stones diseases and obstructive uropathy

Neurogenic bladder and voiding disorders

Vesicoureteric reflux

4. Urinary tract

Clinical condition Clinical condition

Pregnancy with preexisting renal

disease Liver disease

Pregnancy with new renal in-

volvement Specific infections

Essential hypertension Congestive heart failure

Secondary hypertension Sickle cell nephropathy

Hyperlipidemia Dysproteinemias

Diabetic nephropathy Amyloidosis

SLE Metabolic errors

Other collagen disorders

5. Systemic conditions with renal involvement

6. Renal patients with electrolyte and acid base disturbances

7. Cystic renal diseases

8. Renal and urinary tract neoplasia

9. Acute renal injury of various causes

10. Chronic kidney disease due to various causes and stages

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Clinical condition Clinical condition

Acute coronary syndrome Hypertensive emergencies

Pulmonary edema Sepsis and severe acute infections

Cerebrovascular stroke Status epilepticus

Hepatorenal syndrome

11. Medical emergencies associated with renal problems

Clinical condition Clinical condition

Nephrotic syndrome Cystic renal diseases

Congenital/ infantile nephrosis Acute and recurrent urinary tract

infections

Nephritic syndrome Congenital obstructive uropathies

Hemolytic-Uremic syndrome Neurogenic bladder and voiding

disorders

Renal tubular acidosis Vesico-ureteric reflux and reflux

nephropathy

Renal tubular rickets Fluid, electrolyte and acid-base

disturbances

Bartter syndrome Acute Kidney Injury of various

causes

Nephrogenic Diabetes Insipidus Chronic Kidney Disease of various

causes and stages

12. Pediatric renal diseases

The trainees level of participation in the management of pediat-

ric nephrology cases is either observation or assistance in man-

agement only

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RENAL REPLACEMENT THERAPY COMPETENCIES

1. Chronic hemodialysis, initial prescription*

2. Chronic hemodialysis, ongoing management*

3. Acute hemodialysis

4. Slow continuous HD

5. Hemodialysis, session complications*

6. Hemodialysis, access complications*

7. Plasmapheresis

8. Acute peritoneal dialysis*

9. Chronic peritoneal dialysis, initial prescription

10. Chronic peritoneal dialysis, ongoing management

11. Peritoneal dialysis, complications

12. Pretransplant evaluation

13. Transplantation day management

14. Transplantation, postoperative hospital stay management

15. Post transplant follow up

16. Transplantation, acute stage complications

17. Transplantation, long term complications

Cases marked * are specifically required in both adult and pediatric pa-

tients

The logbook must contain evidence of competent performance of the

above mentioned procedures at the level of

1. observation and assistance during the first year of training

2. Independent performance under supervision at the second year of

training

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LIST OF PROCEDURES

1. Renal and urinary tract ultrasonography

2. Native kidney ultrasound guided kidney biopsy

3. Graft ultrasound guided kidney biopsy

4. Insertion of femoral catheters

5. Insertion of double lumen central venous dialysis catheters

6. Insertion of acute peritoneal catheters

7. Renal graft perfusion

Trainees must observe and assist in the above mentioned procedures

during the first year of training

They must perform the above mentioned procedures under supervision

during the second year of training and they may require assistance

Trainees are assumed to have developed competency in routine medical

procedures and advanced life support as part of their training in Inter-

nal Medicine prior to starting the nephrology program.

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Clinical Nephrology 1

Trainees level of participation are

1. observation of case management O

2. Assistance in case management A

3. Supervised management of the case P

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Clinical Nephrology cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Clinical Nephrology Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Clinical Nephrology cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Clinical Nephrology Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Clinical Nephrology cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Clinical Nephrology Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Clinical Nephrology cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Clinical Nephrology Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Clinical nephrology academic activities Log

Activity Type Title of the meeting Trainer’s

signature and date

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Clinical nephrology academic activities Log

Activity Type Title of the meeting Trainer’s

signature and date

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Procedures Log

Trainees level of participation are

1. Observation of procedure O

2. Assistance in performance of procedure A

3. Supervised performance of procedure P

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Procedure: renal ultrasound

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: renal ultrasound

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: native kidney ultrasound guided biopsy

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: graft ultrasound guided biopsy

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: insertion of femoral catheter

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: insertion of double lumen central ve-nous dialysis catheter

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: insertion of acute peritoneal catheter

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: others

Patient’s diagnosis

Level of trainees

participa-tion

Indication and name of procedure

Trainer Signature/

Date O A P

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Procedure: others

Patient’s diagnosis

Level of trainees

participa-tion

Indication and name of procedure

Trainer Signature/

Date O A P

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Dialysis 1

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Hemodialysis and peritoneal dialysis requested skills

1. Pre session clinical evaluation

2. Vascular access puncture or peritoneal catheter insertion

3. Monitoring of machine priming

4. Monitoring of alarm system

5. Recognition and management of different intradialytic complica-

tions

6. Measurement of dialysis session efficacy

7. Monitoring and termination of dialysis session

8. Post-session evaluation

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Chronic hemodialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Chronic hemodialysis Log

Ongoing management From: To:

Level of trainees

participa-tion

Trainer Signature/Date

Initial prescription

Yes No

O A P

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Hemodialysis complications Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Hemodialysis complications Log

Problem

Level of trainees

participa-tion

Trainer Signature/

Date

Management

O A P

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Acute hemodialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Acute hemodialysis Log

Indication for dialysis

Level of trainees

participa-tion

Trainer Signature/

Date

Procedure done

O A P

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Acute peritoneal dialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Acute peritoneal dialysis Log

Indications for dialysis

Level of train-ees participa-

tion Trainer

Signature/Date

O A P

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Chronic peritoneal dialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Chronic peritoneal dialysis Log

Ongoing management From: To:

Level of trainees

participa-tion

Trainer Signature/Date

Initial prescription

Yes No

O A P

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Peritoneal dialysis complications Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Peritoneal dialysis complications Log

Problem

Level of trainees

participa-tion

Trainer Signature/

Date

Management

O A P

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Transplantation 1

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Requested activities for trainees at renal transplantation unit

Activities related to patients preparation

1. Choice of transplantation candidates :

Indications for Transplanation

Contraindications if present

Fitness of the recipient

2. Donor preparation and fitness for donation

3. Immunological matching

Tissue typing

MLC

PRA

Cross matching

4. Radiological workup for donor and recipient

5. Participation in meetings and discussions related to consent for donation and

ethical considerations

The Transplanation procedures

1. Preoperative preparation :

Final cross matching

Infection control measures

Immunosuppression

Hemodialysis

2. Day zero

Anesthesia

Immunosuppression

Kidney perfusion

Monitoring of surgical procedure

Calculation of ischemia time

Fluid and electrolyte monitoring

Cardiovascular monitoring

3. Day1-disharge

Assessment of graft function

Monitoring and adjustment of immunosuppression

Monitoring and management of hospital stay complications like

DVT

Monitoring and management of acute rejection

Monitoring and management of opportunistic infections

Monitoring and management of surgical complications e.g. lympho-

cele

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Followup of transplant recipient

1. Attendance of outpatient transplant clinics

2. Admission and management of complicated cases under supervision

3. Observation and assistance in the formulation of strategies to delay chronic

allograft nephropathy

4. Observation and assistance in second and third transplant workup

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Renal transplantation Log

Patient’s Name Original renal disease Pretransplant evaluation

Skills

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Renal transplantation log

Day zero skills

Level of trainees

participa-tion

Trainer Signature/

Date

Postoperative skills

O A P

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Renal transplantation Log

Patient’s Name Original renal disease Pretransplant evaluation

Skills

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Renal transplantation log

Day zero skills

Level of trainees

participa-tion

Trainer Signature/

Date

Postoperative skills

O A P

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Renal transplantation Log

Patient’s Name Original renal disease Pretransplant evaluation

Skills

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Renal transplantation log

Day zero skills

Level of trainees

participa-tion

Trainer Signature/

Date

Postoperative skills

O A P

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Renal Transplant outpatient clinic

Patient’s Name Date of trans-

plantation Original renal disease

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Renal transplant outpatient clinic

Problem / cause of visit

Level of trainees

participa-tion

Trainer Signature/

Date

Management provided

O A P

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Renal Transplant outpatient clinic

Patient’s Name Date of trans-

plantation Original renal disease

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Renal transplant outpatient clinic

Problem / cause of visit

Level of trainees

participa-tion

Trainer Signature/

Date

Management provided

O A P

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Clinical Nephrology 2 and Renal ICU

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Clinical Nephrology cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Clinical Nephrology Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Clinical Nephrology cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Clinical Nephrology Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Clinical Nephrology cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Clinical Nephrology Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Clinical nephrology academic activities Log

Activity Type Title of the meeting Trainer’s

signature and date

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Clinical nephrology academic activities Log

Activity Type Title of the meeting Trainer’s

signature and date

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Renal ICU cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Renal ICU Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Renal ICU cases Log

Patient’s Name Patient ‘s Hospital

ID Provisional diagnosis

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Renal ICU Cases log

Management provided

Level of trainees

participa-tion

Final diagnosis & Discharge condition

Trainer Signature/

Date O A P

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Procedures Log

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Procedure: renal ultrasound

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: renal ultrasound

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: native kidney ultrasound guided biopsy

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: graft ultrasound guided biopsy

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: insertion of femoral catheter

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: insertion of double lumen central ve-nous dialysis catheter

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Procedure: insertion of acute peritoneal catheter

Patient’s diagnosis

Level of trainees

participa-tion

Indication for procedure

Trainer Signature/

Date O A P

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Dialysis 2

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Chronic hemodialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Chronic hemodialysis Log

Ongoing management From: To:

Level of trainees

participa-tion

Trainer Signature/Date

Initial prescription

Yes No

O A P

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Hemodialysis complications Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Hemodialysis complications Log

Problem

Level of trainees

participa-tion

Trainer Signature/

Date

Management

O A P

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Acute hemodialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Acute hemodialysis Log

Indication for dialysis

Level of trainees

participa-tion

Trainer Signature/

Date

Procedure done

O A P

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Acute peritoneal dialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Acute peritoneal dialysis Log

Indications for dialysis

Level of train-ees participa-

tion Trainer

Signature/Date

O A P

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Chronic peritoneal dialysis Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Chronic peritoneal dialysis Log

Ongoing management From: To:

Level of trainees

participa-tion

Trainer Signature/Date

Initial prescription

Yes No

O A P

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Peritoneal dialysis complications Log

Patient’s Name Patient ‘s Hospital

ID diagnosis

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Peritoneal dialysis complications Log

Problem

Level of trainees

participa-tion

Trainer Signature/

Date

Management

O A P

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Transplantation 2

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Renal transplantation Log

Patient’s Name Original renal disease Pretransplant evaluation

Skills

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Renal transplantation log

Day zero skills

Level of trainees

participa-tion

Trainer Signature/

Date

Postoperative skills

O A P

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Renal transplantation Log

Patient’s Name Original renal disease Pretransplant evaluation

Skills

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Renal transplantation log

Day zero skills

Level of trainees

participa-tion

Trainer Signature/

Date

Postoperative skills

O A P

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Renal Transplant outpatient clinic

Patient’s Name Date of trans-

plantation Original renal disease

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Renal transplant outpatient clinic

Problem / cause of visit

Level of trainees

participa-tion

Trainer Signature/

Date

Management provided

O A P

112

Renal Transplant outpatient clinic

Patient’s Name Date of trans-

plantation Original renal disease

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Renal transplant outpatient clinic

Problem / cause of visit

Level of trainees

participa-tion

Trainer Signature/

Date

Management provided

O A P

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