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Electives - Pathology


Renal Pathology

Elective Number: 2302

Rotation Supervisor: Dr. Helen Cathro, hpc4f@virginia.edu

Duration: 4 weeks

Available: All rotations

A pager is required, but will not be provided.

Time to Report: 8:30 am

Place to Report: New Hospital Expansion room 3028

Typical day: 8:00 am - 5:00 pm

Attendance: Attendance at elective activities is mandatory.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Number of students per rotation: 2

Course Description: This elective is designed for students who wish to explore Nephrology, Transplantation or Pathology as a subspecialty. Diagnosis of medical renal diseases and renal allograft rejection is based on combined histological, ultrastructual and immunofluorescent approaches. The student will review all components of renal biopsies with residents and attendings and will attend conferences. This rotation will acquaint the student with disease diagnosis based on clinicopathologic correlation and the application of several contemporary laboratory approaches.


1. To be familiar with the fundamental patterns of native kidney pathology.
2. To understand the basic principles of renal transplant pathology.
3. To be able recognize aggressive kidney disease in the form of crescentic glomerulonephritis and thrombotic microangiopathy.

1. Patient Care
- To recognize the importance of correlating the clinical history, laboratory results and medications with the findings on the renal biopsy.
- To evaluate the renal biopsy in a systematic fashion by compartment.
- To be familiar with the use of the immunofluorescent microscope and understand the difference between clinically relevant findings and artifact using this technique.
- To be able to integrate electron microscopy into the final diagnosis of the renal biopsy.

2. Medical Knowledge
- To learn the clinical features of common diseases affecting the native kidney; namely, diabetes, hypertensive arterionephrosclerosis, IgA nephropathy, minimal change disease, focal segmental glomerulosclerosis, crescentic glomerulopathy, drug-associated interstitial nephritis and thrombotic microangiopathy.
- To know the typical histomorphologic features of the above-listed diseases by light microscopy, immunofluorescence and electron microscopy.
- To understand the criteria for diagnosis of acute cellular and acute antibody mediated rejection in the renal allograft, as well as be able to recognize infection, drug toxicity and acute tubular damage in this setting.

3. Practice-based Learning and Improvement
- To appreciate the use of special stains in the light microscopic evaluation of native kidney disease.
- To understand the need for immunofluorescence and electron microscopy in the complete evaluation of native and transplant renal biopsies.
- To understand the importance of triaging core renal biopsies and to develop the ability to perform triaging competently.

4. Professionalism
- To understand the importance of communicating with clinical colleagues in order to obtain clinical information and convey preliminary results clearly.

5. Systems Based Care and Practice
- To understand how histotechnologists, nephrology fellows and radiologists work together as a team in order to ensure the correct processing of renal biopsies that need to be triaged at nights and weekends.