Point-of-care ultrasonography (POCUS) is a limited ultrasound study performed by the clinician at bedside as a component or an adjunct to physical examination. POCUS has multiple applications in nephrology practice including evaluation of obstructive uropathy, objective assessment of volume status, arteriovenous access assessment, and procedural guidance. However, unlike specialties such as emergency medicine, POCUS training is not yet integrated into most nephrology fellowship curricula, and the sonographic applications taught vary widely among fellowship programs. In this article, we have used our institutional experience to provide a roadmap or blueprint for nephrology programs looking to create a POCUS program. We provide an overview of the curriculum including the basic organization, applications taught, online resources, milestone development, and quality assessment. We also discuss the nuances of POCUS workflow and perspectives on billing for these limited studies. In addition, we share the evaluation forms and sample documentation we use in our program. Future support, in the form of endorsed nephrology society guidelines, are needed before POCUS training is universally incorporated across nephrology fellowship programs.

Purpose of Review:The purpose of this review is to provide a brief summary about the current state of knowledge regarding the circadian rhythm in the regulation of normal renal function. Recent findings:There is a lack of information regarding how the circadian clock mechanisms may contribute to the development of diabetic kidney disease. We discuss recent findings regarding mechanisms that are established in diabetic kidney disease and are known to be linked to the circadian clock as possible connections between these two areas Summary: Here we hypothesize various mechanisms that may provide a link between the clock mechanism and kidney disease in diabetes based on available data from humans and rodent models.

Calcific uremic arteriolopathy (CUA) or Calciphylaxis is a rare disease typically seen in end stage renal disease patients on dialysis and is associated with high mortality rates, mainly because of sepsis. Medial calcification of the dermal arterioles is the characteristic histologic finding together with vascular thrombosis and ischemic necrosis. CUA involves legs, abdomen and gluteal region in majority of the patients. Herein, we present a case of CUA of the glans penis in a uremic patient. Unfortunately, the patient died of sepsis in a few weeks after initiating dialysis.

Key Clinical MessageDrug‐induced acute interstitial nephritis is an important cause of unexplained acute kidney injury in hospitalized patients. It can present with nonspecific clinical features, and renal biopsy should be considered for definitive diagnosis. Removal of the offending agent along with early initiation of corticosteroid therapy is the mainstay of treatment.

Introduction Lack of awareness for chronic kidney disease (CKD), including end stage kidney disease (ESKD) and their management options is a major impediment to patients being able to select and use home dialysis therapies. While some instruments have been developed to measure CKD awareness, we lack validated instruments to evaluate patients’ awareness of ESKD and dialysis modalities. This study is part of multipart project for developing and validating an ESKD-centric disease awareness questionnaire. Methods A team of specialty renal care experts developed a 45-items questionnaire encompassing the subdomains of General Kidney Knowledge, CKD Knowledge, and ESKD Knowledge. Item reduction analysis—specifically, calculation of item difficulty and item discrimination index scores—was used to items for further review and potential removal. Results Index scores were reviewed in conjunction with consideration of theoretical and substantive item content to reduce the number of items in the questionnaire, resulting in a 32-item questionnaire, retaining 5/10 items in the general kidney knowledge subdomain, 14/21 items in the CKD knowledge subdomain, and 13/14 items in the ESKD knowledge subdomain. Retained items ranged from 0.19 to 0.79 on the difficulty index, and from 0.31 to 0.81 on the discrimination index. Scores for percent correct on the reduced questionnaire spanned 0% to 87.5% correct on the full scale, 0% to 100% correct on the General Knowledge subdomain, 0% to 100% on the CKD Knowledge subdomain, and 0% to 92.3% on ESKD Knowledge subdomain. Conclusions The questionnaire developed and refined in this study constitutes a patient disease awareness instrument that spans a range of difficulty, and yet shows strong ability to distinguish between patients with varying levels of disease awareness. This study is the first in part of a multistep project to addresses a gap in measuring ESKD specific knowledge. Accurate assessment of patients’ disease awareness through a validated instrument can allow identification of knowledge domains leading to positive impacts on their healthcare decisions and improve targeted patient education efforts.