The division has an active pediatric nephrology fellowship program designed to train sub-specialist pediatricians for academic careers. Clinical responsibilities are concentrated in the first year of the three-year fellowship. Fellows will manage a wide variety of patients with glomerular diseases, tubular disorders, congenital anomalies of the kidneys and urinary tract, hereditary kidney diseases, hypertension, acute kidney injury, chronic kidney disease, end-stage kidney disease, and other conditions. The fellow will follow their own cohort of patients in the outpatient clinic. They will be exposed to and learn to prescribe hemodialysis, peritoneal dialysis, continuous renal replacement therapy, modified aquapheresis, and apheresis for a variety of clinical scenarios.

Opportunities for both clinical and basic science research in years two and three are available through divisional research and through the outstanding faculty of Washington University in St. Louis School of Medicine. Efforts are made to carefully place each fellow into a thriving research environment appropriate to his/her background and interests to optimize success. Several of our recent fellows are in or have successfully completed: a) dual Med-Peds nephrology fellowship; or b) fast-track residency program into fellowship; or c) a Masters in Clinical and Translational Science research.

Research training in the division focuses on several areas of nephrology: renal development, glomerular diseases, genetics, hypertension, chronic kidney diseases, and complications in pediatric dialysis patients and kidney transplant recipients. Translational studies of new therapies for kidney diseases have emerged from projects led by fellows.

A recent fellow translational project looked at the association of APOL1 high-risk alleles in primary hypertension or glomerular diseases in African-American children. Bench discoveries in the Hruska lab regarding pathophysiology of CKD have included the demonstration that chronic kidney disease directly diminishes skeletal anabolism by inhibiting the function of the BMP and Wnt proteins. Mechanisms of signal transduction through these pathways are current investigational pursuits under the fellowship training program at the present time. In addition, active research programs related to phosphorus, vascular calcification and their cardiovascular complications are available along with new therapeutic approaches to these disorders.

Clinical and translational research in transplantation looks at the impact of complications such as post-transplant infections, malignancies and mineral disorders in chronic rejection. Ongoing studies by fellows or faculty members are investigating autoantibody development or vascular calcification measures. Other recent studies have assessed aortic stiffness in patients with hypertension, beta-2 microglobulin in diagnosis of acute kidney injury.

In addition, division faculty actively participate in multi-center studies through NAPRTCS, PNRC, SCOPE, GLEAN, CKiD, AWARE, AWAKEN, and IROC.

Pediatric nephrology fellowship highlights

Pediatric nephrology fellowship highlights flyer:
Clinical Care Training: We are the primary service for our Nephrology patients, >30 chronic dialysis patients, On track for 15-18 kidney transplants this year.
We perform our own procedures: 50 Kidney biopsies/yr, CRRT> 700 days/yr, Aquapheresis for infants, apheresis ~400 sessions per year, >70 ambulatory BP monitorings/year, Pulseware analysis and velocity.
Allied Rotations: Renal pathology, Urology, Radiology.
Multi-disciplinary Clinics: Uroiogy/Nephrology, Rheumatology/nephrology, Aortic and Renovascular Center for Hypertension, Fontan clinic, Adult/Pediatric Nephrology Transition Clinic.
Environment & Education: 9 pediatric nephrologists with complementary interests, Local and national nephrology advocacy opportunities, QI and research collaboratives participation (NAPRTCS, IROC, SCOPE, CureGN CKiD), Dual med-peds fellowship available and has been used, Contiguous facility with adult Barnes-Jewish Hospital, Well developed educational curriculum fellows teach in equal rotation
with faculty.
Research Experience: Interdisciplinary basic, translational, or clinical research opportunities in chronic kidney disease, vascular biology, single cell sequencing, matrix biology and transplantation across entire campus, Faculty members, hold multiple  extramural research grants from NIH and foundations, 18·30 publications/year by our division, Funds to attend teaching conferences, Departmental T32 funding or MSCI degree available.
Mentorship: All our recent fellows have presented an accepted first author abstract at a national meeting In their 3rd year, 5/9 faculty members were listed in Best Doctors In America, Faculty are involved in national society committees and
projects, 7 prior trainees rose to division chief positions

Conference schedules

Mondaypediatric nephrology conference
Tuesdaynephrology research seminar
Wednesdayadult pathophysiology conference
Thursdayadult clinical case conference
Fridaypediatric nephrology conference

Radiology Urology Nephrology (RUN) conference once every six weeks