Urine Nephrology Now
FOAMed-Inspired Resources for Students in Nephrology
Three tiers of nephrology education, built by a clinician and educator with 25 years at the bedside. The Primer is your quick-start guide — the “how to” of nephrology practice, a rapid way for learners to understand the challenges seen in kidney medicine every day. The Lecture Series goes deeper into core diagnostic and therapeutic approaches grounded in physiology, pathophysiology, pharmacology, anatomy, and evidence-based medicine. The Clinical Mastery Series is where real-world nephrology lives — how I approach difficult and often conflicting priorities when patients don’t follow the textbook, using anatomy, physiology, pathophysiology, pharmacology, and evidence to navigate complex clinical care.
Explore our Complementary Educational Resources below for podcasts, presentations, AI tools, and specialized training modules.
🔑 The Skeleton Key Philosophy
Understanding kidney disease the way it’s clinically encountered
Just as a skeleton key opens many locks, three fundamental diagnostic tools unlock the vast majority of kidney diseases. In practice, the BMP (or RFP/CMP), the urinalysis with microscopy, and renal imaging are often what create the first indication that a nephrology consult is needed. They are the reason the phone rings.
This philosophy mirrors how kidney disease actually presents — not in textbook chapters, but through objective findings we can measure, visualize, and interpret at the bedside.
🧪 Clinical Chemistry
The BMP / RFP / CMP
- Creatinine & eGFR reveal kidney function
- Electrolytes (Na, K, Cl, HCO₃) expose homeostatic derangements
- Calcium, magnesium, phosphorus complete the mineral picture
- Patterns in these values guide differential diagnosis
🔬 Urinalysis
UA with Microscopy
- Protein, blood, casts reveal glomerular pathology
- Specific gravity assesses concentrating ability
- pH and crystals guide acid-base & stone evaluation
- Fresh microscopy unlocks ALL renal physiology
📸 Renal Imaging
Structural & Anatomic Insights
- Kidney size distinguishes acute from chronic disease
- Hydronephrosis identifies obstruction
- Echogenicity, masses, stones provide structural diagnosis
- Doppler reveals vascular pathology
💡 The Power of This Approach
By mastering these three diagnostic pillars — clinical chemistry, urinalysis with microscopy, and imaging — you gain the ability to evaluate, diagnose, and manage the overwhelming majority of kidney diseases encountered in clinical practice. These are the tools that generate the consult. They are where nephrology begins.
But sometimes patients forget to bring their owner’s manual. They don’t follow a typical pattern, they have an unusual diagnosis, or they present with conflicting findings that the textbook never warned you about. That’s where the Clinical Mastery Series and advanced cases come in — real-world nephrology for the patients who didn’t read the textbook either.
The Primer
The Quick-Start Guide to Nephrology Practice
Lecture Series
A deeper dive into core nephrology diagnostic and therapeutic approaches
Originally developed for the University of Dubuque PA Program, the Lecture Series has grown into a comprehensive resource for all non-nephrology practitioners seeking to deepen their understanding of kidney medicine.
🎓 The Skeleton Key Approach to Clinical Nephrology
Grounded in physiology, pathophysiology, pharmacology, anatomy, and evidence-based medicine — the diagnostic and therapeutic approaches I use every day
🔑 Core Philosophy: Five Tests Unlock Almost All Renal Disease
Built around the revolutionary "Skeleton Key" approach - just as a skeleton key opens many locks, five essential tests unlock the vast majority of renal diseases:
The original skeleton key
Essential mineral additions
Cellular energy and CKD-MBD
The ultimate skeleton key that unlocks ALL renal physiology
📚 Comprehensive Modular System
Featuring 12 major topic areas with 50+ interactive sub-modules, 2025 evidence-based guidelines, and built-in clinical calculators for real-world application.
Major Topic Areas
Interactive Sub-modules
Clinical Calculators
Evidence-Based Guidelines
28 Interactive Clinical Cases
*Case-Based Learning with Integrated Questions & Module Links*
🎯 Complete 28-Case Progressive Curriculum
25 foundational cases with 350+ integrated questions, plus 3 advanced Clinical Mastery cases for when patients forget to bring their owner’s manual — cardiac amyloidosis masquerading as heart failure, SLE vs. endocarditis with overlapping serologies, and cardiogenic shock hiding behind a “normal” ejection fraction
🔗 Six-Category Assessment Structure with Module Integration
Each enhanced case features 15-25 interactive questions spanning six learning categories, with direct links to relevant lecture modules for comprehensive understanding:
Baseline knowledge testing before case review
Progressive diagnostic decision-making
Critical decision points during patient care
Advanced pathophysiology exploration
Competency verification against course goals
Multi-system synthesis scenarios
📚 Progressive Learning Pathways
Prerenal, ATN, AIN, prevention, rhabdomyolysis
Urgent to nuanced Na/K/Ca disorders
Metabolic disorders and mixed overlays
Nephritic → nephrotic, RPGN, IgA
Progression, MBD, anemia, cardiorenal
AKI-RRT decision, chronic planning, access
Pregnancy, transplant, palliative, advanced
SLE vs. endocarditis, cardiac amyloidosis, preserved EF trap
🎓 Complete Learning Experience: Each case integrates 4-6 lecture modules with real-time calculators, interactive explanations, and comprehensive module crosslinks for systematic nephrology education from medical student through fellowship level.
Total Cases
Interactive Questions
Integrated Modules
Clinical Calculators
Assessment Categories
Medical Associates - Staff Training
*Interactive Clinical Practice Excellence Modules*
📋 Comprehensive Staff Education Programs
Evidence-based training modules with interactive assessments for clinical staff excellence
🩺 Current Training Module: Blood Pressure Measurement
Complete staff training on modern blood pressure measurement techniques based on 2025 AHA/ACC guidelines, featuring the transition from manual to automated measurement methods:
Serial AOBP protocol replacing manual methods
Understanding aneroid vs automated devices
24-hour ABPM and home BP training
Training patients for accurate home measurements
📚 Interactive Learning Features
- 17 Case-Based Questions: Real clinical scenarios with immediate feedback
- Protocol Compliance: Step-by-step guides for proper measurement technique
- Evidence-Based Content: 2025 AHA/ACC guidelines and latest research
- Visual Learning: Tables, diagrams, and decision trees for clinical practice
- Practice Scenarios: Common errors and how to avoid them
Interactive Questions
AHA/ACC Guidelines
Core Topic Areas
Evidence-Based
📊 Complete Educational System
From foundational learning with The Primer to advanced clinical practice with the Lecture Series
🎓 Lecture Series
Comprehensive review for students, residents and fellows
12
Major Topic Areas
50+
Interactive Sub-modules
25+
Clinical Calculators
2025
Evidence-Based Guidelines
📚 The Primer
Introduction to kidney disease fundamentals
28
Foundational Chapters
11
Audio Lectures Available
4.6
Hours of Audio Content
2
AI Presentations
🚀 Complementary Educational Resources
Supporting materials that enhance both The Primer and Lecture Series learning experience
PubMed Literature Search
Search recent medical publications across 50+ specialties organized by category: Primary Care, Medical Specialties, Surgical, Women's Health, Behavioral Health, Rehabilitation, Oncology, and more. Results ranked by journal impact factor tier with a curated database of ~500 high-impact specialty journals.
Monthly Literature Digest
Subscribe to receive monthly email digests of the highest-impact publications in your specialty. Choose from 50+ specialties and get curated articles ranked by journal impact factor delivered to your inbox each month.
Medical Associates - Staff Training
Interactive staff training modules for clinical practice excellence. Currently featuring comprehensive blood pressure measurement training based on 2025 AHA/ACC guidelines with 16 case-based questions covering device accuracy, measurement techniques, and out-of-office monitoring protocols.
Student Podcasts
Audio companion to The Primer with 11 comprehensive lectures covering acid-base disorders, kidney disease, and electrolyte management. Perfect preparation for the advanced concepts in the Lecture Series.
Educational Presentations
Visual learning materials including PowerPoint and Gamma slides that complement both The Primer's foundational concepts and the Lecture Series' advanced clinical applications.
Artificial Intelligence in Healthcare
Cutting-edge AI applications in nephrology that bridge foundational knowledge from The Primer with the advanced clinical decision-making tools featured in the Lecture Series.
Deep Dives
Deep Dives are now part of the Clinical Mastery Series. Access advanced cardiorenal reviews, HFpEF roundtable, and more.
Laboratory Focus
Detailed interpretation of kidney function tests and urinalysis, building on Primer basics and integrating with Lecture Series' "Skeleton Key" diagnostic approach.
Current Content
Latest advances in nephrology including SGLT2 inhibitors and modern AKI management, keeping both Primer and Lecture Series content current with evolving practice.
About Dr. Andrew Bland, MD, MBA, MS
Dr. Bland is a practicing nephrologist and founding partner of the Medical Associates Department of Nephrology, board certified in internal medicine, pediatrics, and adult nephrology. A physician leader with over two decades of experience spanning clinical nephrology, medical education, healthcare quality, and health informatics, he has taught hundreds of medical students and residents, developing a reputation for making complex kidney physiology accessible and engaging.
His career includes leadership roles as System Chief Medical Officer, Medical Director at The Joint Commission, System Chief Quality Officer, and Chief Health Information Officer. He was named one of Becker's Healthcare Top 100 CMOs to Know in 2020 and is a nationally recognized speaker on quality, safety, and medical staff affairs.
The Urine Nephrology Primer represents years of teaching experience distilled into an approachable introduction, while the Lecture Series showcases his innovative "Skeleton Key" approach to clinical nephrology, designed for comprehensive review by students, residents, and fellows.
Education: MD, University of Illinois College of Medicine; Combined Internal Medicine & Pediatrics Residency, St. Francis Medical Center; Nephrology Fellowship, University of Iowa Hospitals and Clinics; MBA, UMass Amherst; MS Predictive Analytics, Northwestern University
Faculty Appointments: Associate Professor, University of Dubuque PA Program; Associate Clinical Professor of Medicine & Pediatrics, University of Illinois College of Medicine
Professional Memberships: Fellow, American College of Physicians; Fellow, American Academy of Pediatrics; American Society of Nephrology; American College of Physician Executives (Life Member)
Teaching Philosophy: From foundational understanding in The Primer to advanced clinical decision-making in the Lecture Series, Dr. Bland believes in progressive, evidence-based nephrology education that leverages data, analytics, and innovative technology to drive superior clinical outcomes.
How This Site Was Built
Educational Design, AI Transparency & Scope
Educational Design: ICBL-ERP
Every layer of this site integrates six evidence-based learning principles into what we call Interactive Case-Based Learning with Embedded Retrieval Practice (ICBL-ERP):
Active Learning
Interactive calculators, expandable teaching points, and embedded assessment rather than passive reading.
Retrieval Practice
400+ questions woven directly into case narratives, not bolted on as a separate quiz.
Case-Based Learning
Progressive disclosure — history, exam, labs, imaging, decisions — mirroring actual clinical reasoning.
Immediate Corrective Feedback
Every question explains why the correct answer is right and why distractors are wrong.
Multimedia Design
Text, audio podcasts, interactive visualizations, calculators, and clinical algorithms — operationalizing Universal Design for Learning.
Spaced Repetition
The three-tier structure creates natural spacing — encounter concepts in the Primer, revisit in lectures, apply in cases, integrate at the mastery level.
AI as Force Multiplier
All clinical content, teaching frameworks, and case designs come from my nephrology practice and teaching experience. AI served as the force multiplier for deployment — converting clinical expertise into well-structured interactive HTML at a pace that would have been impossible through traditional faculty-only authoring.
The result is roughly a 10:1 efficiency gain over traditional authoring: what would have taken years of evenings and weekends was built in months. The domain expert is still the bottleneck for knowledge work. AI removes the barriers between expertise and delivery.
This is a model I believe has significant implications for medical education. Domain experts have always been the bottleneck for educational content development. AI doesn’t replace the expert — it removes the barriers between expertise and delivery.
Scope & Limitations
One Clinician’s Approach
Nephrology has genuine variation in practice patterns — from volume management strategies to dialysis initiation timing to GN treatment protocols. The content here represents my clinical perspective, informed by KDIGO, AHA/ACC, and current evidence. Reasonable clinicians approach many of these topics differently, and that diversity is a feature of our field, not a bug.
A Public Beta
There are rough edges — some visual inconsistencies between sections, content areas still in development (transplant, pregnancy nephrology, genetic renal diseases), and certainly errors I haven’t caught. I’d rather get it in front of people now and improve with feedback than wait for perfection.
Complements, Not Replaces
This site is an educational scaffold meant to help build frameworks and clinical reasoning. It complements guidelines, UpToDate, and the primary literature — it doesn’t replace them.
Paying It Forward
The #FOAMed Community in Nephrology
#FOAMed — Free Open Access Medical Education —
is a global movement coined by Dr. Mike Cadogan in 2012, dedicated to sharing medical knowledge without barriers.
From podcasts to tweetorials to interactive curricula, FOAMed democratizes learning for clinicians worldwide.
In nephrology, this movement has produced some of the most innovative educational platforms in all of medicine.
This project exists because of the extraordinary FOAMed and nephrology education community that has been sharing knowledge freely for years.
I am grateful for the efforts these educators make every day to ensure that advances in nephrology are accessible
to every student, every trainee, and every practitioner — regardless of where they train or practice.
Urine Nephrology Now grew from teaching PA students at the University of Dubuque PA Program and practicing nephrology at Medical Associates in Dubuque, Iowa. What began as lecture preparation evolved into a comprehensive learning pathway. This platform is new and evolving, and I look forward to feedback and discussion regarding differences in approach to diagnosing and treating clinical problems in kidney medicine. All content on this site is freely available for educational use.
Nephrology FOAMed Platforms
PBFluids
Joel Topf, MD — the original nephrology FOAMed voice. Set the standard for making renal physiology accessible through digital media.
NephJC
Founded by Swapnil Hiremath, MD & Joel Topf, MD — evidence-based journal club on social media, building a global nephrology learning community.
Neph Madness 2026
Annual bracket-style tournament gamifying nephrology education. Deep-dive scouting reports on the field’s most important debates. Hosted on the AJKD Blog.
Freely Filtered Podcast
Landmark nephrology trial discussions for your commute. Audio companion to NephJC’s live journal club chats.
NephJC Internship
Structured training in nephrology literature and FOAMed. Mentorship and a pathway into academic nephrology education for the next generation.
Renal Fellow Network
Matthew Sparks, MD — the go-to platform for nephrology trainees. Clinical pearls, career advice, and fellow-driven content.
GLOMCON
Glomerular disease case conferences and education. Expert-led discussions of complex GN cases with global participation.
NephSIM
Interactive nephrology simulation cases. Board-style questions and case-based learning for trainees and practicing nephrologists.
The NephJC Team
The people who make nephrology’s premier FOAMed platform possible — meet the full team
Founding Editors
Joel Topf, MD
Swapnil Hiremath, MD
Managing Editors
Cristina Popa, MD
Brian Rifkin, MD
Freely Filtered Hosts
S. Ambruso • N. Arora • J. Cohen • J. Waitzman • P. Yenebere
Basic Science
K. Hyndman, PhD • J. Lin, MD • C. Vlasschaert, MD
Associate Editors
H. Alzayer • M. Flores • A. Gaddy • P. Meena • P. Prasad • S. Suresh • Sabarinath S • J. Teakell • S. Thakare • I. Tiwari • J. Willows
Special Contributors
D. Bajpai (Visual Abstracts) • T. Caza (Tweetorials) • G. Colbert (Newsletter) • M. Bapat (NephTrials) • E. Zeitler (AI)