Paediatric nephrology - sub-specialty

A paediatric nephrologist manages children and young people with chronic and acute kidney disease, including the provision of dialysis and kidney transplantation. Find out more about this clinical area. Access the current syllabus for training in this clinical area, as well as the revised syllabus coming in August/September 2021.

What is expected from a paediatric nephrology trainee?

A paediatric nephrologist is a clinician who deals with the diagnosis, investigation and management of chronic and acute kidney disease, including the provision of dialysis and renal transplantation. Paediatric nephrologists have detailed knowledge of renal physiology, including fluid management and disturbances in electrolytes and acid-base balance.

They are skilled in the management of acute kidney injury (AKI), which may be managed conservatively or with renal replacement therapy (RRT), including peritoneal dialysis (PD), haemodialysis (HD), and continuous venovenous haemodialysis (CVVHD) and continuous venovenous haemodiafiltration (CVVHF). They are also skilled in the management of chronic kidney disease (CKD), including the pre-dialysis phase, peritoneal dialysis, haemodialysis and transplantation.

Paediatric nephrologists also develop expertise in the management of children and infants with:

  • congenital anomalies of the renal tract
  • nephrotic syndrome
  • glomerulonephritis
  • vasculitis
  • inherited and acquired forms of tubulopathy
  • urinary tract infection (UTI)
  • vesicoureteric reflux (VUR)
  • renal stone disease
  • hypertension
  • inborn errors of metabolism
  • inherited nephropathies.

CKD is a life-long condition and paediatric nephrologists are frequently involved in the care of patients from birth all the way through to the successful transition into adult renal care.

RCPCH Progress curriculum and syllabi for level 3 training

As of 1 August 2018, sub-specialty trainees use the RCPCH Progress level 3 generic syllabus alongside the RCPCH Progress paediatric nehprology sub-specialty syllabus. Download both documents below

In addition to the generic learning outcomes for level 3, paediatric nephrology trainees must fulfil the sub-specialty learning outcomes:

  • Demonstrates extensive knowledge of renal physiology, including fluid management and disturbances in electrolytes and acid-base balance.
  • Manages the diagnosis, investigation and management of acute and chronic kidney disease, including the provision of renal replacement therapy and renal transplantation.
  • Demonstrates proficiency in all aspects of the management of children and infants requiring acute and long-term dialysis, including peritoneal dialysis, haemodialysis, continuous venovenous haemodialysis and continuous venovenous haemodiafiltration.
  • Manages children and infants with congenital anomalies of the renal tract, nephrotic syndrome, glomerulonephritis, vasculitis, inherited and acquired forms of tubulopathy, UTI and vesicoureteric reflux, renal stone disease, hypertension, inborn errors of metabolism, and inherited nephropathies.
  • Shows expertise in the transition of renal patients to adult care.

Revised syllabus coming in August/September 2021

We spoke with clinicians working in this sub-specialty, and agreed some enhancements to the sub-specialty syllabus. The revised version is approved by the General Medical Council (GMC) for use as of August/September 2021.

Dr Maduri Raja, a trainee in paediatric nephrology, introduces the revisions to this syllabus:

A summary of the changes:

  • The illustrations for Learning Outcome (LO) 1 have been updated ('Demonstrates an understanding'... section has been removed and one new Illustration added). 
  • LO2 has been amended (terms renal replacement therapy and renal transplantation have now been removed). 
  • Key Capabilities (KCs) have also been amended (three new KCs have been added and one removed). 
  • Illustrations have since been updated (AKI - 'Applies knowledge of'... section removed and ‘Demonstrates the following skills'... section has now been updated. CKD and Transplantation sections have been replaced with new Illustrations). 
  • LO3 has been amended (KRT added) and KCs relating to this section have been amended (two added and one removed). 
  • Illustrations have now been updated and a new section on Transplantation added. 
  • LO4 and KC4 has been reworded, and KC5 added. Illustrations have been removed and amended. 
  • LO5 has also been removed. 
  • The Assessment Grid has been updated to reflect the changes to the KCs.

You can download the revised syllabus below, as well as a document that maps the Learning Outcomes from the 2018 version to the revised version.

If you have any questions contact us on qualityandstandards@rcpch.ac.uk.