The Cedars-Sinai Medical Center/Veterans Administration West Los Angeles Medical Center joint fellowship program offers a two-year postgraduate fellowship providing training in both clinical nephrology and renal science. Fellows normally spend equal time between Cedars-Sinai and VA West Los Angeles Medical Center. Efforts are made to make the program flexible and to meet individual needs. Therefore, the second year of fellowship can be tailored to the individual's interests.
During the renal consultation rotation, fellows will interact with and will be supervised by both full-time staff nephrologists and physicians who belong to the voluntary medical staff. Clinical activities are concerned with the care and management of patients with diseases of the kidneys and disorders of body fluids. Experience gained during the period of training is broad and equips one to approach any renal problem with confidence. We have active programs in inpatient and outpatient hemo- and peritoneal dialysis. The current outpatient dialysis population consists of approximately 120 patients. A large and active dialysis unit allows the acquisition of experience in various dialytic procedures. Outpatient clinic facilities allow the long-term followup and management of patients with renal diseases and hypertension. There are eight to 10 hospitalized patients followed by the Division of Nephrology at any given time. Management of these patients provides the fellows with exposure to a broad spectrum of clinical problems, including acute renal failure, hypercalcemia, glomerulonephritis and complex electrolyte and acid-base disorders. In addition to the acquisition of clinical skills, the fellow is able to gain in-depth experience in acute dialysis, continuous arteriovenous hemofiltration, chronic peritoneal dialysis renal biopsy.
The Division of Nephrology works closely with the Department of Surgery in the management of renal transplant patients, and approximately 120 kidney transplants are performed each year at Cedars-Sinai with excellent patient and organ survival. Fellows take an active and primary role in the management of these patients from the time of initial hospitalization until their discharge. All fellows attend active transplant clinics, which follow patients weekly or bimonthly for the first three months post-transplant, and then yearly. We also offer a one-year renal transplant fellowship program accredited by the AST-ASN.
The Nephrology Section at VA West Los Angeles Medical Center runs very active inpatient and outpatient consultative and primary care services. The Renal Inpatient Consultation Service is comprised of the renal attending, first- or second-year fellow, house officers and medical students. An academic VA nephrologist serves as the renal attending on the Consultation Service. Referrals to the Consultation Service come from every service of the hospital and cover a wide variety of fluid and electrolyte, acid-base, mineral metabolism and intrinsic renal disorders. The daily rounds on the Consultation Service focus on the differential diagnosis and treatment of the broad spectrum of disorders that are seen in the hospital. Various forms of renal replacement therapy for acute renal failure are available and prescribed as indicated. The Nephrology Section is also the major consultative service for complicated or secondary forms of hypertension.
The Nephrology Section has several outpatient clinics. The Renal Clinic serves as an outpatient renal consultative resource, as well as the primary care clinic for patients with progressive kidney failure and those who have received renal transplants. Because all of the clinical nephrology fellows participate in the Renal Clinic throughout their two years, this clinic provides an opportunity for longitudinal followup of diagnostic tests and treatment responses for patients with kidney diseases. The Renal-Hypertension Clinic provides consultations for patients who have difficult to manage hypertension, who may have secondary hypertension or who have chronic kidney disease and hypertension. The Dialysis Clinics include a chronic hemodialysis clinic, a self-care hemodialysis clinic and a peritoneal dialysis clinic. The hemodialysis unit currently treats over 50 patients with chronic renal failure. The Dialysis Unit has been designated a Center of Excellence by the Department of Veterans Affairs.
Fellows will spend four months dedicated to research with one of the faculty at either institution. Nephrology faculty members at Cedars-Sinai are engaged in active research endeavors, including clinical and animal investigation in the areas of hypertension, transplant, immunology, immunopathology and research outcomes. The Adult Nephrology Research Program operates in close collaboration with the Pediatric Nephrology and Pathology Research Programs. The Pediatric Nephrology Laboratory is fully equipped with state-of-the-art technology.
The VA Nephrology Section conducts a wide variety of clinical and laboratory research activities. Clinical research interests include the prevention and treatment of complications of chronic kidney failure including renal osteodystrophy and anemia, the development of new treatments for patients with renal diseases and hypertension, the prevention of the progression of chronic renal disease and the study of patient outcomes with different modes of dialysis. Laboratory studies include the study of acid-base regulation by the kidney, the mechanism of the regulation of phosphate transport, the role of angiotensin in the regulation of kidney function, regulation of angiotensin receptor expression, the control of parathyroid gland secretion in renal failure, the pathogenesis of renal osteodystrophy and the mechanisms of nephrotoxic renal cell injury.
A full conference schedule is maintained by Cedars-Sinai's Division of Nephrology and the Department of Medicine and is listed below. Conferences are attended by faculty, fellows, residents and students. A number of distinguished visiting professors serve to enrich the conference program.
- Renal Grand Rounds: Major subjects in nephrology are discussed by the faculty and distinguished visiting professors at weekly conferences. A monthly combined Renal-Endocrine Grand Rounds is also held.
- Journal Club: Nephrology fellows, residents and faculty present in-depth reviews of 2 papers from the current literature, on a weekly basis.
- Transplantation Case Conference: Nephrology faculty, transplantation surgeons and nurses review current and future transplant recipients.
- Biopsy Review: An in-depth review of renal biopsies by highly qualified renal pathologists. One-hour sessions are held twice per week in addition to a Renal Grand Rounds pathology conference once per month.
- Fluid and Electrolyte Conference: Discussions of current case problems related to major acid-base and electrolyte disorders are held weekly.
- Peritoneal Dialysis Conference: Discussion of issues in peritoneal dialysis held monthly.
- UCLA Grand Rounds: Case presentations are followed by in-depth discussions of relevant issues. Some of the Grand Rounds sessions have been featured as "Nephrology Forums" in Kidney International.
- Pathophysiology of Kidney Disease and Research Methodology Seminar: A yearlong lecture series covering all aspects of kidney diseases, dialysis, transplantation, water and electrolyte physiology, as well as a sound introduction to research methodology and clinical investigation.
- Research in Progress: Faculty members present data and review their ongoing research projects.
- Clinical Conference: Discussion of recent cases from the consultation service or clinics.
- Dialysis Quality Assurance Conferences: Multidisciplinary conference to review current and future dialysis patients.
- Stanley C. Jordan, MD, Professor of Pediatrics and Director of Adult and Pediatric Nephrology
- Alice Peng, MD, Assistant Professor of Medicine and Director of Nephrology Fellowship Program
- Rafael Villicana, MD, Assistant Professor of Medicine and Nephrologist
- Arthur H. Cohen, MD, Professor of Medicine and Pathology and Renal Pathologist
- Cynthia C. Nast, MD, Professor of Medicine and Pathology and Renal Pathologist
- Glenn Nagami, MD, Professor of Medicine at UCLA and Chief of the Nephrology Division
- Arnold Felsenfeld, MD, Professor of Medicine at UCLA and Director of the Hypertension Clinic
- Charles Kleeman, MD, Professor of Medicine (Emeritus) at UCLA and Staff Physician
- Jeffrey Kraut, MD, Professor of Medicine at UCLA and Director of the Dialysis Program
- Barton Levine, MD, Adjuvant Professor of Medicine at UCLA and Assistant Chief of the Nephrology Section and Director of the Renal Clinic
Any questions can be addressed to:
| Alice Peng, MD |
| Director, Nephrology Fellowship Program |
| Cedars-Sinai Medical Center |
| 8635 West 3rd St, Suite 590W |
| Los Angeles, CA 90048 |
| Phone: (310) 423-7880 |
| Fax: (310) 423-4678 |
| Send Us a Message |
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