Back
Practice of nephrology has undergone significant changes in recent years, with the introduction of new technologies and approaches in the management of renal diseases.
Considering the need to adapt to these changes, it is important to align the nephrology training with current demands and advancements, especially in critical nephrology.
In formal training of nephrologists there is a notorious diversity of programs between universities and countries, resulting in different kind of nephrologists and roles in clinical practice. In an attempt to stablish the minimal requirements of nephrology training, we made a survey as a diagnosis of actual state of training and perception of acquired competences in critical nephrology to identify areas of potential improvement in our country.
An anonymous survey was conducted to assess the perception of competences acquired during the training of nephrologists in Colombia regarding critical nephrology. The survey was distributed via social media, and included 10 questions distributed in epidemiological data, working field, availability of multiorgan support (MOS) and perception of relevance and quality of acquired competences during formation in: ultrasound use (guide catheter insertion and POCUS), renal replacement therapies (RRT) and MOS.
The survey was sent on February 2023 with a reminder every 2 weeks until closure on April 2023.
Answers to the survey were received from 100 nephrologists.
The majority of the respondents were male (81%), and most nephrologists work in critical nephrology (55%).
Most received their training in Colombia (82%), but there were also trained in other Latin American countries (15%).
The majority (44%) graduated as nephrologists after 2015, the less frequent answers were from graduated before 2000 (16%).
Renal replacement therapies (RRT) such as hemodialysis (HD) and peritoneal dialysis (PD) were widely available in the practice locations of the surveyed nephrologist (HD 78%, PD 51%). (Table 1) Training was considered enough, mainly for HD (78%) and continuous renal replacement therapies (CRRT) (65%) and less in PD (55%).
Regarding CRRT, more recent nephrologists expressed a higher perception of competence compared to graduates before 2000. (table 2)
Conclusions
In Colombia there is a vast availability of renal replacement therapies in ICU, but few centers have MOS support.
This study highlights the need to adjust nephrology training programs in Colombia to include and enhance training in the use of ultrasound and multiorgan support therapies.
The importance of continuous education is also emphasized to fill gaps in university training and improve nephrologist´s competences in clinical practice.